比较术前心理准备与咪达唑仑预给药对行腺样体扁桃体切除术儿童焦虑的影响。
A comparison of preoperative psychological preparation with midazolam premedication to reduce anxiety in children undergoing adenotonsillectomy.
机构信息
Department of Anesthesiology, Tabriz University of Medical Science, Tabriz, Iran.
Department of Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran.
出版信息
Afr J Paediatr Surg. 2020 Jan-Jun;17(1-2):10-14. doi: 10.4103/ajps.AJPS_62_17.
INTRODUCTION
Considering the multiplicity of adenotonsillectomy in children 2-10-year old at the paediatric surgery centres, patient anxiety leads to an increase in surgical and anaesthetic complications. Patients' unfamiliarity with surgical and anaesthetic interventions may increase their stress. Midazolam premedication reduces patient anxiety. In previous studies, psychological preparation before surgery using understandable terms to children, has reduced their anxiety. The aim of this study was to compare and study behavioural reflections among the children in two groups: the first group was prescribed oral midazolam, and the second group received psychological preparation with the booklet about anaesthesia and anaesthesia-resident explanation.
MATERIALS AND METHODS
This study is a clinical trial conducted on 48 children undergoing adenotonsillectomy. Children in the first group (midazolam group) received oral midazolam 0.5 mg/kg, 20 min before surgery. A booklet containing pictures and information about anaesthesia and the operating room was given to the second group (psychological preparation group) the night before surgery and anaesthesia resident explained the booklet to the children. The anxiety level was measured in both groups using the State-Trait Anxiety Inventory for Children questionnaire the night before surgery and on the morning of surgery (after giving midazolam to Group II). The results were analysed using SPSS.
RESULTS
In this study, 58.3% of the first group and 45.8% of the second group were male. The mean age of the first and second groups was 8.45 ± 1.86 and 9.12 ± 1.72 years, respectively. The anxiety in the first group significantly decreased in the morning before surgery compared to the night before operation (P < 0.001). The anxiety in the second group significantly decreased in the morning before surgery compared to the night before as well (P < 0.001).
CONCLUSION
The results showed that midazolam and psychological preparation prior to surgery can reduce the anxiety of children before adenotonsillectomy.
简介
考虑到儿科外科中心 2-10 岁儿童腺样体扁桃体切除术的多样性，患者的焦虑会导致手术和麻醉并发症增加。患者对手术和麻醉干预的不熟悉可能会增加他们的压力。咪达唑仑术前用药可减轻患者焦虑。在之前的研究中，使用儿童易懂的术语对手术进行术前心理准备，可降低他们的焦虑。本研究旨在比较和研究两组儿童的行为反应：第一组给予口服咪达唑仑，第二组接受麻醉手册和麻醉医生讲解的心理准备。
材料和方法
这是一项对 48 例腺样体扁桃体切除术患儿进行的临床试验。第一组（咪达唑仑组）患儿术前 20 分钟口服咪达唑仑 0.5mg/kg。第二组（心理准备组）在手术前一晚给予包含麻醉和手术室图片和信息的手册，并由麻醉医生向患儿讲解手册。两组患儿在手术前一晚和手术当天早上（给第二组患儿咪达唑仑后）使用儿童状态-特质焦虑问卷评估焦虑程度。结果采用 SPSS 进行分析。
结果
本研究中，第一组 58.3%和第二组 45.8%为男性。第一组和第二组的平均年龄分别为 8.45±1.86 岁和 9.12±1.72 岁。与手术前一晚相比，第一组患儿手术当天早上的焦虑程度显著降低（P<0.001）。与手术前一晚相比，第二组患儿手术当天早上的焦虑程度也显著降低（P<0.001）。
结论
结果表明，术前使用咪达唑仑和心理准备可以降低腺样体扁桃体切除术前儿童的焦虑。
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