“Sevo the Dragon” takes the stress out of surgery and anesthesia for young patients

Thanks to a collaborative group at Lucile Packard Children’s Hospital Stanford, a dose of fun and games is helping ease the stress and anxiety that many young patients feel before heading into surgery.

“Surgery and anesthesia can be a major cause of stress and anxiety for many young patients and their families,” said Sam Rodriguez, MD, pediatric anesthesiologist. “Our goal is to engage children in play that flexes their imagination during the key moments prior to surgery to minimize attention to stressful stimuli around them and increase cooperation.”

In 2015, Rodriguez and fellow anesthesiologist Thomas Caruso, MD, introduced the Bedside Entertainment Theatre (BERT), which allows patients to choose from a menu of age-appropriate entertainment options that they can watch up until the moment they fall asleep in the OR. The distraction helps reduce nerves, crying and stress, which can impact clinical outcomes when it comes to the induction of anesthesia and postsurgical recovery.

Their latest creation is an interactive video game called Sevo the Dragon, which was developed in collaboration with Stanford-affiliated software engineer Joseph Lang. The interactive experience takes a necessary part of anesthesia — breathing anesthesia medicine through a mask to fall asleep — and transforms it into a fun game that can be played on a tablet or projected on the BERT screen. Patients begin the game by selecting a dragon avatar and choosing a food for the dragon to “cook” using his fire breath. As patients breathe into the anesthesia mask, the onscreen dragon breathes fire onto the food — be it pizza, tacos or cake — to heat it up. Anesthesiologists use cues like “one, two, three, RAWR!” to coach patients with their breathing as anesthesia gases are slowly administered through the mask until the patient falls asleep.

Caruso and Rodriguez have teamed up with some of their colleagues— including child life specialists, Stanford researchers and engineers — to launch the CHARIOT — Childhood Anxiety Reduction through Innovation and Technology program at Lucile Packard Children’s Hospital Stanford. CHARIOT’s goal is to implement new technologies in the hospital that are medically nontraditional yet familiar to children in an effort to engage and distract them during stressful periods, such as when they are undergoing procedures or getting imaging studies done. Some of the technologies that are being piloted include virtual reality experiences, new tablet-based apps and interactive bedside projector-based games.

The Sevo the Dragon game is in its early stages of rollout in the perioperative unit, but it is already making a big impact. “The game travels with the patient as he or she is wheeled from pre-op to the OR,” Caruso explains. “Maintaining distraction during this moment helps mitigate the natural feelings of stress that patients feel as they say goodbye to their family members and move into the surgical setting.”

The game will be become available to all Packard Children’s patients undergoing anesthesia within the next one to two months.