Department of Surgery, Children's Hospital of Shanxi Province, No. 13 of Xinmin North Street, Taiyuan, 030001, China.
Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, No. 29 of Twin Towers Temple Street, Taiyuan, 030001, China.
Eur Arch Otorhinolaryngol. 2023 Dec;280(12):5475-5482. doi: 10.1007/s00405-023-08222-3. Epub 2023 Sep 14.
To investigate the effect of parental presence during induction of anesthesia (PPIA) in relieving preoperative anxiety of children undergoing tonsillectomy and adenoidectomy.
One hundred and sixty children undergoing tonsillectomy and adenoidectomy were divided into the control group and the trial group. The control group received routine nursing in the operation room, while anesthesia was induced in the trial group children in the presence of their parents as part of the routine nursing. The differences in heart rate and mean dynamic pressure during pre-operative visit and anesthesia induction between the two groups were observed and recorded. The Modified Yale Preoperative Anxiety Scale (m-YPAS) and the Induction Compliance Checklist (ICC) were scored. The anxiety status of the children and their family members in the two groups was scored at different times, and the psychological stress of anesthesiologists during anesthesia induction was scored by a visual analogue scale. The differences in each index between the two groups were compared. Operation time and costs in-hospital were also compared.
Compared with the control group, the heart rate and blood pressure scores as well as the ICC in the trial group were lower than those in the control group (P < 0.01). On comparing the scores of m-YPAS between the two groups, we observed that the scores of the children in the trial group were lower than those in the control group before entering the induction room and anesthesia induction (P < 0.01). There was no statistical difference between the scores of the children in the trial group and the control group on the day of operation and on the way to the operating room (P > 0.05). The nursing satisfaction scores of the family members in the trial group were significantly superior to those in the control group (P < 0.01). The scores of the visual analogue scale for psychological pressure of anesthesiologists during anesthesia induction were higher in the trial group than in the control group (P < 0.05). The operation time and costs in study group were both significantly higher than those of control group (P < 0.05).
PPIA can significantly reduce preoperative anxiety and surgical physiological stress response in children undergoing tonsillectomy and adenoidectomy, and it is worth being encouraged.
探讨父母陪伴麻醉诱导(PPIA)对缓解扁桃体切除术和腺样体切除术患儿术前焦虑的效果。
将 160 例行扁桃体切除术和腺样体切除术的患儿分为对照组和试验组。对照组在手术室接受常规护理,而试验组患儿则在常规护理中接受父母陪伴麻醉诱导。观察并记录两组患儿术前访视和麻醉诱导时的心率和平均动态压差异。采用改良耶鲁术前焦虑量表(m-YPAS)和诱导依从性检查表(ICC)评分。对两组患儿不同时间的焦虑状况及其家属的焦虑状况进行评分,并采用视觉模拟评分法对麻醉诱导时麻醉医师的心理应激进行评分。比较两组各指标的差异。还比较了两组的手术时间和住院费用。
与对照组相比,试验组的心率和血压评分以及 ICC 均低于对照组(P<0.01)。比较两组患儿 m-YPAS 评分,发现试验组患儿进入诱导室和麻醉诱导前的评分低于对照组(P<0.01)。两组患儿在手术当天和进入手术室的路上的评分无统计学差异(P>0.05)。试验组患儿家属的护理满意度评分明显优于对照组(P<0.01)。麻醉诱导期间麻醉医师心理压力的视觉模拟评分试验组高于对照组(P<0.05)。试验组的手术时间和住院费用均明显高于对照组(P<0.05)。
PPIA 可显著减轻扁桃体切除术和腺样体切除术患儿的术前焦虑和手术生理应激反应,值得鼓励。