1.Anxiety Reaction in Children During Cast Removal using Oscillating Saw versus Cast Shear - A Randomised, Prospective Trial
Mohamed-Zain NA ; Jamil K ; Penafort R ; Singh A ; Ibrahim S ; Abdul-Rashid AH
Malaysian Orthopaedic Journal 2021;15(No.2):122-128
Introduction: To compare the anxiety levels demonstrated
by children during cast removal procedure between
oscillating saw vs cast shear methods.
Material and methods: A randomised prospective study of
102 children (mean age 8.3 ± 3.5 years) with fractures
involving upper or lower limbs. Children undergoing
removal of cast were divided into 2 groups; either by an
oscillating saw or a cast cutting shear. The level of anxiety
was assessed by recording the heart rate with a portable
fingertip pulse oximeter before, during and after removal of
the cast. Objective assessment was performed by
documenting the fear level on Children’s Fear Scale (CFS).
Results: There was a significant increase in the heart rate of
children during cast removal while using the oscillating saw
compared to cast shear (p<0.05). The noise level produced
by the saw exceeded 80 dB (mean 103.3 dB). The fear level
was significantly lower in the cast shear group (p<0.05).
Conclusion: The noise produced by the oscillating saw was
associated with an increased anxiety level in children
undergoing cast removal. Cast shear is a simple and
inexpensive instrument that can be used for cast removal in
overly anxious children.