MacLaren Jill E, Kain Zeev N
Department of Anesthesiology, Yale School of Medicine, New Haven, CT 06520, USA.
J Pediatr Psychol. 2008 Apr;33(3):248-57. doi: 10.1093/jpepsy/jsm073. Epub 2007 Sep 12.
To evaluate children's sleep patterns before and after ambulatory surgery and to identify predictors of sleep decrements following surgery.
Participants were 55, 6- to 12-year-old children undergoing tonsillectomy and adenoidectomy. Sleep was assessed using actigraphy for 5 nights prior to and 5 nights following surgery. Parent state and trait anxiety, and child perioperative anxiety and temperament were assessed. Data on postoperative pain and use of analgesics were collected.
Children had significantly less efficient sleep following surgery than before surgery. Approximately one-third of children demonstrated clinically significant decrements in sleep efficiency. Discriminant function analysis indicated less sociable and more anxious children were more likely to experience these sleep decrements, as were children who experienced greater pain in the postoperative period.
Children's sleep is an important consideration in recovery from surgery and this article takes a first step toward identifying predictors of the development of clinically significant sleep disruptions following surgery.
评估儿童门诊手术后的睡眠模式,并确定术后睡眠减少的预测因素。
研究对象为55名6至12岁接受扁桃体切除术和腺样体切除术的儿童。术前5晚和术后5晚使用活动记录仪评估睡眠情况。评估父母的状态焦虑和特质焦虑,以及儿童围手术期焦虑和气质类型。收集术后疼痛和镇痛药物使用的数据。
与术前相比,儿童术后睡眠效率显著降低。约三分之一的儿童睡眠效率出现临床上显著的下降。判别函数分析表明,社交性较差且焦虑程度较高的儿童更有可能出现这些睡眠减少情况,术后疼痛更严重的儿童也是如此。
儿童睡眠是手术恢复过程中的一个重要考量因素,本文朝着确定术后临床上显著睡眠障碍发生的预测因素迈出了第一步。