Nell Hodgson School of Nursing, Emory University, Atlanta, GA.
J Perianesth Nurs. 2024 Feb;39(1):6-9. doi: 10.1016/j.jopan.2023.05.001. Epub 2023 Aug 30.
The majority of pediatric patients and their parents experience fear and anxiety related to their surgical experience. Traditionally, anesthesia providers addressed this anxiety with pharmacologic therapy, such as benzodiazepines, to provide amnesia and anxiolysis. However, this approach has been questioned due to the potential for developmental neurotoxicity, among other drawbacks. Further, the pharmacological approach does not remove preexisting anxiety that the child and parent experience before arrival and during check-in. Pediatric and parental preparation before surgery is an important step that continues to be inconsistently addressed, particularly in lower-resource community hospitals where the majority of routine pediatric outpatient procedures occur. This care gap provides an opportunity for preanesthesia nurses to intervene with valid, evidence-based preoperative education tools aimed at pediatric patients and their parents. Providing these resources before the day of surgery allows time for child-directed, at-home practice as often as the parent(s) and patient choose. Use of available resources from a leading children's hospital, nurses can create a tailored, developmentally appropriate preoperative education plan for pediatric patients and their parents, providing families with the power to create a positive surgical experience.
大多数儿科患者及其家长在手术过程中都会感到恐惧和焦虑。传统上,麻醉师通过使用苯二氮䓬类药物等药物治疗来缓解这种焦虑,以提供遗忘和抗焦虑作用。然而,由于存在发育神经毒性等其他缺点,这种方法受到了质疑。此外,这种药理学方法并不能消除儿童和家长在到达和登记期间已经存在的焦虑。手术前的儿科和家长准备是一个重要的步骤,但在资源较少的社区医院中,这一步骤往往没有得到一致的重视,而这些医院正是大多数常规儿科门诊手术的发生地。这一护理差距为麻醉前护士提供了机会,可以使用针对儿科患者及其家长的有效、基于证据的术前教育工具进行干预。在手术当天之前提供这些资源,可以让儿童在家长的指导下,根据自己的意愿在家中进行多次练习。护士可以利用一家领先儿童医院的现有资源,为儿科患者及其家长制定量身定制、适合其发展阶段的术前教育计划,使家庭有能力创造积极的手术体验。