Franco Castanys Teresa, Jiménez Carrión Anabel, Ródenas Gómez Frederic, Clemente García Sandra, Melero Mascaray Alícia, Janeiro Amela Marisa, Busquets Bonet Jordi
Department of Anesthesiology, Perioperative Care and Pain Medicine. Division of Pediatric Anesthesia, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
Paediatr Anaesth. 2023 May;33(5):377-386. doi: 10.1111/pan.14639. Epub 2023 Feb 7.
There is a high incidence of perioperative anxiety in the pediatric population, with adverse side effects, such as emergency delirium and maladaptive postoperative behaviors.
The study's objective was to compare the level of preoperative anxiety in children after standard preparation plus a virtual tour of the operating room vs. standard preparation alone.
PATIENTS/METHODS: This was a prospective single-center, randomized, controlled, blinded trial with parallel assignment, registered as NCT04043663. Eligible subjects were healthy children (ASA I-II) aged 4-12, scheduled for outpatient surgery. Five visits were conducted during the study, two at the hospital and three over the phone. Variables assessed were child's anxiety through the modified Yale Perioperative Anxiety Scale, demographic data, cooperation with induction through the Induction Compliance Checklist, preoperative parental anxiety through the State-Trait Anxiety Inventory and Anxiety Visual Analog Scale, the postoperative delirium degree through the Pediatric Anesthesia Emergence Delirium Scale, the presence of behavioral changes through the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery, and the overall parental satisfaction.
A total of 125 participants were included; 61 (48.8%) of them were randomized to the Virtual Tour Group (VT+) and 64 (51.2%) to the Non-virtual Tour Group (VT-). Yale Preoperative Anxiety Scale results in VT+ vs. VT- were mean 27.26 vs. 32.57, and median 23.4 (CI 95% 23.4-23.4) vs. 23.4 (CI 95% 23.4-33.4), (p = .0086). In the VT+ group, satisfaction was higher for questions one (p = .0213), three (p = <.0001), and four (p = .0130). Throughout the study, we observed a significant reduction in perioperative anxiety in the VT+ group, facilitating anesthetic induction in perfect (p = .018) and moderate compliance (p = .0428). The other variables did not show statistically significant differences.
Our study confirms previous studies that found virtual tours for perioperative patients may reduce perioperative anxiety and improve satisfaction. We found no impact on longer-term outcomes.
儿科患者围手术期焦虑发生率较高，会产生诸如急性谵妄和不良术后行为等不良副作用。
本研究的目的是比较标准准备加手术室虚拟参观与单纯标准准备后儿童术前焦虑水平。
患者/方法：这是一项前瞻性单中心、随机、对照、双盲试验，采用平行分组，注册号为NCT04043663。符合条件的受试者为计划进行门诊手术的4至12岁健康儿童（ASA I-II级）。研究期间进行了五次访视，两次在医院，三次通过电话进行。评估的变量包括通过改良耶鲁围手术期焦虑量表评估的儿童焦虑、人口统计学数据、通过诱导依从性检查表评估的诱导合作情况、通过状态-特质焦虑量表和焦虑视觉模拟量表评估的术前家长焦虑、通过儿科麻醉苏醒期谵妄量表评估的术后谵妄程度、通过门诊手术出院后行为问卷评估的行为变化情况以及家长总体满意度。
共纳入125名参与者；其中61名（48.8%）被随机分配至虚拟参观组（VT+），64名（51.2%）被分配至非虚拟参观组（VT-）。VT+组与VT-组的耶鲁术前焦虑量表结果分别为均值27.26对32.57，中位数23.4（95%置信区间23.4 - 23.4）对23.4（95%置信区间23.4 - 33.4），（p = .0086）。在VT+组中，问题一（p = .0213）、问题三（p = <.0001）和问题四（p = .0130）的满意度更高。在整个研究过程中，我们观察到VT+组围手术期焦虑显著降低，促进了完美诱导（p = .018）和中度依从性（p = .0428）。其他变量未显示出统计学显著差异。
我们的研究证实了先前的研究结果，即围手术期患者的虚拟参观可能会降低围手术期焦虑并提高满意度。我们发现对长期结果没有影响。
