基于视频学习的术前呼吸训练可减少学龄前儿童的苏醒期谵妄：一项随机临床试验。

Pre-operative breathing training based on video learning reduces emergence delirium in preschool children: A randomized clinical trial.

作者信息

Zhang Li-Nan, Liu Yi, Guo Qian-Qian, Ling Yu-Ting, Li Fang, Zheng Yan-Ling, Chen Mu-Yao, Chen Feng-Hong, Jiang Nan

机构信息

Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2(nd) Road, Guangzhou 510080, China; Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Guangzhou 510635, China.

Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2(nd) Road, Guangzhou 510080, China.

出版信息

J Clin Anesth. 2022 Aug;79:110788. doi: 10.1016/j.jclinane.2022.110788. Epub 2022 Apr 13.

DOI:10.1016/j.jclinane.2022.110788

PMID:35429906

Abstract

STUDY OBJECTIVE

Emergence delirium is a common complication in preschool children after general anesthesia and may result in undesirable complications. This study aimed to determine whether breathing training after watching an informative video during the pre-operative visit could reduce the incidence of emergence delirium in preschool children after otorhinolaryngologic surgery under general anesthesia.

DESIGN

A single-center, double-blinded, randomized controlled trial.

SETTING

Perioperative care.

PATIENTS

A total of 170 children undergoing otorhinolaryngologic surgery, aged 3-7 years, ASA physical status I or II were involved.

INTERVENTIONS

Patients were randomized to receive breathing training during the pre-operative visit (Training group) or to receive pre-operative visit only (Control group) the day before surgery.

MEASUREMENTS

Emergence delirium was measured by the Pediatric Anesthesia Emergence Delirium score during the anesthesia recovery time. Data regarding extubation time and post-anesthesia care unit stay time were collected.

MAIN RESULTS

Children who received breathing training during the pre-operative visit had a significantly lower incidence of emergence delirium than those who only underwent the pre-operative visit (10.4% vs. 35.1%, P < 0.001). The awakening time score and the maximum score in the post-anesthesia care unit were significantly lower in the training group compared with the control group [4.4 ± 3.4 vs. 6.9 ± 4.2, P < 0.001 and 5.0 (5.0) vs 7.0 (7.0), P = 0.001, respectively]. We found no differences in the extubation time and post-anesthesia care unit stay time between groups.

CONCLUSIONS

We concluded that breathing training based on video learning during the pre-operative visit in preschool children undergoing otorhinolaryngologic surgery could significantly decrease the incidence of emergence delirium.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (Reference number: ChiCTR1900026162); registered on September 24, 2019.

摘要

研究目的

苏醒期谵妄是学龄前儿童全身麻醉后常见的并发症，可能导致不良后果。本研究旨在确定术前访视期间观看科普视频后进行呼吸训练是否可降低学龄前儿童在全身麻醉下接受耳鼻喉科手术后苏醒期谵妄的发生率。

设计

单中心、双盲、随机对照试验。

设置

围手术期护理。

患者

共有170例年龄在3至7岁、美国麻醉医师协会（ASA）身体状况为I或II级的接受耳鼻喉科手术的儿童参与。

干预措施

患者被随机分为两组，一组在术前访视期间接受呼吸训练（训练组），另一组在手术前一天仅接受术前访视（对照组）。

测量指标

在麻醉恢复期间，采用小儿麻醉苏醒期谵妄评分来评估苏醒期谵妄情况。收集拔管时间和麻醉后护理单元停留时间的数据。

主要结果

术前访视期间接受呼吸训练的儿童苏醒期谵妄的发生率显著低于仅接受术前访视的儿童（10.4%对35.1%，P<0.001）。与对照组相比，训练组的苏醒时间评分和麻醉后护理单元的最高评分显著更低[分别为4.4±3.4对6.9±4.2，P<0.001；5.0（5.0）对7.0（7.0），P=0.001]。我们发现两组之间的拔管时间和麻醉后护理单元停留时间没有差异。