提前暴露于动画手术相关图画书对学龄前儿童术前焦虑和麻醉诱导的影响：一项随机对照试验。
Effects of advance exposure to an animated surgery-related picture book on preoperative anxiety and anesthesia induction in preschool children: a randomized controlled trial.
机构信息
Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
出版信息
BMC Pediatr. 2022 Feb 14;22(1):92. doi: 10.1186/s12887-022-03136-1.
BACKGROUND
Our aim was to investigate whether early surgical preparation by reading an animated picture book about procedure-related events could reduce the preoperative anxiety in preschoolers.
METHODS
131 patients, aged 3-6 years and underwent elective minor surgery were randomized either to a control or a picture book group. Both groups received general information about surgery and anesthesia in pre-anesthesia clinic. Patients in study group also received a surgery-depicting picture book for them to read at home a week earlier before surgery. Child anxiety was evaluated with the modified Yale Preoperative Anxiety Scale Short Form in six observing time points before anesthesia induction, and the compliance of anesthesia induction was assessed with the Induction Compliance Checklist (ICC).
RESULTS
There were significantly lower anxiety scores in picture book group than in control group at the time of ready for intravenous cannulation in operating room [51.9 (23.6) vs. 67.2 (22.0); mean difference 15.3; 95% confidence interval (CI) 6.4-24.1; P = 0.001] and at the time of pre-anesthesia visit [27.8 (7.6) vs. 33.2 (13.6); mean difference 5.3; 95%CI 0.93-9.8; P = 0.018]. No significant differences of anxiety levels were found between two groups at other observed time points: in the anesthesia outpatient clinic, in the holding area, at separation from parent to operating room (OR), and on entrance to OR (P = 0.584, 0.335, 0.228, 0.137, respectively). The percentage of children with poor induction compliance (i.e., ICC ≥ 6) was higher in control group compared with that in picture book group [38% vs.21%; odds ratio(95%CI): 0.78(0.61-0.99); P = 0.041].
CONCLUSIONS
Home-reading an animated picture book to get familiar with the perioperative events earlier prior to surgery could effectively reduce the preoperative anxiety level and increase the compliance during the induction of anesthesia in preschool children.
TRIAL REGISTRATION
ChiCTR2000033583, 06/06/2020 www.chictr.org.cn .
背景
本研究旨在探讨术前阅读有关手术过程的动画图画书是否可以减轻学龄前儿童的术前焦虑。
方法
将 131 名年龄在 3-6 岁之间、行择期小手术的患儿随机分为对照组或图画书组。两组患儿均在麻醉前诊室接受手术和麻醉的一般信息介绍。研究组患儿还在术前一周阅读一本描述手术的图画书。采用改良耶鲁术前焦虑量表短表在麻醉诱导前的六个观察时间点评估儿童焦虑，采用诱导依从性检查表（ICC）评估麻醉诱导的依从性。
结果
与对照组相比，图画书组患儿在手术室准备行静脉穿刺时[51.9（23.6）比 67.2（22.0）；均数差 15.3；95%置信区间（CI）6.4-24.1；P=0.001]和麻醉前就诊时[27.8（7.6）比 33.2（13.6）；均数差 5.3；95%CI 0.93-9.8；P=0.018]的焦虑评分显著降低。两组患儿在其他观察时间点的焦虑水平无显著差异：在麻醉门诊、等候区、与父母分离至手术室（OR）和进入手术室（OR）时（P=0.584、0.335、0.228、0.137）。与图画书组相比，对照组患儿的诱导不依从率（即 ICC≥6）更高[38%比 21%；比值比（95%CI）：0.78（0.61-0.99）；P=0.041]。
结论
术前在家阅读动画图画书以更早熟悉围手术期事件可有效降低学龄前儿童的术前焦虑水平，并提高麻醉诱导的依从性。
试验注册
ChiCTR2000033583，2020 年 6 月 6 日，www.chictr.org.cn。
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