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Clowns as Treatment for Preoperative Anxiety in Children: A Randomized Controlled Trial

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00609960
Recruitment Status : Completed
First Posted : February 7, 2008
Last Update Posted : February 7, 2008
Information provided by:
Sheba Medical Center

Brief Summary:
This study wants to test the hypothesis that trained clowns can reduce anxiety in children undergoing general anesthesia. We will compare the effect of the clowns to the commonly used anti-anxiety medication we commonly use

Condition or disease Intervention/treatment Phase
Pre Operative Anxiety Behavioral: clowns present Drug: midazolam Not Applicable

Detailed Description:

The perioperative environment, often anxiety-provoking for adults, may be quite frightening for children. The detrimental effects of preoperative anxiety are not confined to the preoperative period. Anxiety during induction of anesthesia is correlated with increased distress early in the postoperative period, (Holms Knud, Kain) and maladaptive behavior will follow for the first 2 weeks following surgery in up to 54% of children.

Many preoperative systems allow parental, pharmacologic, and anticipatory interventions to facilitate a relaxed perioperative environment for children. Unfortunately, scheduling conflicts, side effects, and limited resources conspire to limit their usefulness. For example, only 10% of respondents in a recent survey used parental presence during induction of anesthesia (PPIA) for a majority of their patients. This may be due to the belief by some that parental anxiety may in fact increase children's anxiety. (Bevans) According to the same survey, only 50% of children undergoing surgery receive sedating premedication. (Kain). Distraction techniques, such as the use of toys or video games, may also decrease perioperative anxiety, however their effectiveness during induction of anesthesia is not well characterized. The efficacy of toys and video games is somewhat dependent upon the child reaching certain developmental milestones. Anesthesiologists continue to search for an easy and comprehensive method for anxiety reduction in the pediatric surgical population. We propose that specially trained professional clowns may allay preoperative anxiety and result in a smooth anesthetic induction.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 65 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Care Provider)
Primary Purpose: Supportive Care
Official Title: Clowns as Treatment for Preoperative Anxietyin Children- a Randomized Controlled Trial
Study Start Date : January 2006
Actual Primary Completion Date : January 2007
Actual Study Completion Date : January 2007

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anxiety

Arm Intervention/treatment
No Intervention: 1
no medication or clowns present during the preopertaive phase
Active Comparator: 2
midazolam a anxiolytic drug was given in the preoperative phase
Drug: midazolam

Active Comparator: 3
clowns where present during the preoperative phase
Behavioral: clowns present
clowns present during the proccess of induction of anesthesia

Primary Outcome Measures :
  1. anxiety level [ Time Frame: waiting area and enterance to OR -1 hour ]

Information from the National Library of Medicine

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Ages Eligible for Study:   2 Years to 8 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • ASA I and II
  • Children aged 2-8 years

Exclusion Criteria:

  • Previous surgery
  • ASA > II
  • Parents' refusal

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00609960

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Sheba Medical Center
Tel Hashomer, Ramat Gan, Israel, 52621
Sponsors and Collaborators
Sheba Medical Center
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Principal Investigator: Ilan Keidan, MD Sheba Medical Center, Israel

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Responsible Party: Ilan Keidan MD, Director pediatric anesthesia, Sheba Medical Center Identifier: NCT00609960     History of Changes
Other Study ID Numbers: SHEBA-05-3739-IK-CTIL
First Posted: February 7, 2008    Key Record Dates
Last Update Posted: February 7, 2008
Last Verified: January 2008

Keywords provided by Sheba Medical Center:
children anesthesia anxiety clowns

Additional relevant MeSH terms:
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Anxiety Disorders
Mental Disorders
Adjuvants, Anesthesia
Hypnotics and Sedatives
Central Nervous System Depressants
Physiological Effects of Drugs
Anti-Anxiety Agents
Tranquilizing Agents
Psychotropic Drugs
Anesthetics, Intravenous
Anesthetics, General
GABA Modulators
GABA Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action