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影响接受牙科修复全身麻醉的儿童术前焦虑的因素。

Factors affecting preoperative anxiety in children undergoing general anaesthesia for dental rehabilitation.

作者信息

Al-Jundi S H, Mahmood A J

机构信息

Dept. of Preventive Dentistry, Dental School, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

Eur Arch Paediatr Dent. 2010 Feb;11(1):32-7. doi: 10.1007/BF03262707.

Abstract

AIM

The primary aim was to examine anxiety levels, and to identify factors affecting preoperative anxiety among healthy children undergoing general anaesthesia for dental rehabilitation. A secondary aim was to assess parental distress and attitude to accompanying their children during this procedure.

STUDY DESIGN

Observational cross sectional study.

METHODS

Anxiety levels of 118 children admitted to the Day Case unit of King Abdullah teaching hospital in Irbid, Jordan, for dental rehabilitation under general anaesthesia (GA) were assessed at different phases (before and during induction of GA) using the Global Mood Score (GMS) with parental presence. The effect of certain variables such as age, sex, reason for referral, past GA experience, accompanying parent, and parental distress, on children's anxiety during this procedure were assessed using multivariate analysis. The level of significance was <0.05. Parental distress and attitudes to accompanying their children were assessed using a structured questionnaire.

RESULTS

There was a significant increase of child anxiety on GMS reaching its highest level in phase three (induction phase). A multivariate test (MANOVA) showed that previous experience of the child with GA, and reason for referral to dental rehabilitation under GA, significantly predicted child anxiety (P-value of 0.019 and 0.012) respectively. However, parental distress, accompanying person, age, and sex of the child, did not affect child anxiety. Parental distress was at its highest level in phase three, mothers were significantly more stressed than fathers and parental distress was significantly increased when a child was <5 years of age.

CONCLUSION

Factors contributing to increased child anxiety during induction of GA for dental rehabilitation were age, previous GA experience, and referral for GA at a very young age. Most parents, especially mothers, were distressed during the induction phase, therefore sufficient preoperative preparation of those children and parents is necessary to achieve best patient management.

摘要

目的

主要目的是检查焦虑水平,并确定影响接受牙科修复全身麻醉的健康儿童术前焦虑的因素。次要目的是评估父母在此过程中的痛苦程度以及陪伴孩子的态度。

研究设计

观察性横断面研究。

方法

对约旦伊尔比德阿卜杜拉国王教学医院日间病房收治的118名接受全身麻醉(GA)进行牙科修复的儿童,在不同阶段(GA诱导前和诱导期间)使用总体情绪评分(GMS)并在父母在场的情况下评估其焦虑水平。使用多变量分析评估某些变量,如年龄、性别、转诊原因、既往GA经历、陪伴父母以及父母的痛苦程度,对儿童在此过程中焦虑的影响。显著性水平为<0.05。使用结构化问卷评估父母的痛苦程度及其陪伴孩子的态度。

结果

儿童在GMS上的焦虑显著增加,在第三阶段(诱导期)达到最高水平。多变量检验(MANOVA)表明,儿童既往GA经历以及因GA转诊至牙科修复的原因,分别显著预测了儿童的焦虑(P值分别为0.019和0.012)。然而,父母的痛苦程度、陪伴者、儿童的年龄和性别,均未影响儿童的焦虑。父母的痛苦程度在第三阶段最高,母亲比父亲的压力显著更大,当孩子<5岁时,父母的痛苦程度显著增加。

结论

导致牙科修复GA诱导期间儿童焦虑增加的因素包括年龄、既往GA经历以及在非常小的年龄因GA转诊。大多数父母,尤其是母亲,在诱导期感到痛苦,因此对这些儿童和父母进行充分的术前准备对于实现最佳的患者管理是必要的。

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