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缓解小儿术前焦虑,我们目前进展如何?——一项全国性调查。

Allaying Pediatric Preoperative Anxiety, Where are we Now? - A Nationwide Survey.

作者信息

Shah Shreya Bharat, Sinha Renu, Hussain Sana Yasmin, Kumar Amit, Gupta Anju

机构信息

Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.

出版信息

J Indian Assoc Pediatr Surg. 2023 Nov-Dec;28(6):479-485. doi: 10.4103/jiaps.jiaps_114_23. Epub 2023 Nov 2.

Abstract

BACKGROUND

Preoperative anxiety (PA) in children is a common phenomenon associated with various negative patient outcomes. Allaying PA is accepted as a standard of care, but its use is not universal and often overlooked. This survey is designed to evaluate the nationwide current practice patterns and attitudes of anesthesiologists toward the practice of allaying PA in children.

MATERIALS AND METHODS

A questionnaire of 25 questions, including information on methods of relieving PA in children, reasons for noncompliance, and associated complications, was framed. It was circulated among members of the Indian Society of Anaesthesiologists through an online survey of Google Forms and manually.

RESULTS

Four hundred and fifty anesthesiologists were surveyed. Responses were predominantly from anesthesiologists practicing in medical colleges across the country. Although 97% of the surveyed respondents practiced anxiety-relieving strategies, only 37% used it consistently. Seventy-three percent of anesthesiologists practiced both pharmacological and nonpharmacological techniques. The most common reason for avoiding premedication was an anticipated difficult airway (88%). Inadequate sedation was a commonly reported problem. Ninety-five percent of participants felt that PA-relieving strategies should be integral to pediatric anesthesia practice. The most common reason for not following these practices was an inadequate hospital infrastructure (67%). Ninety-seven percent of the participants believed that more awareness is required on this crucial perioperative issue.

CONCLUSION

Only 37% of the surveyed anesthesiologists consistently used some form of PA-relieving strategy and the practice varied widely. Further improvement and team approach involving anesthesiologists, surgeons, and nurses is required to ensure the quality of pediatric PA-relieving services and establish it as a standard of care.

摘要

背景

儿童术前焦虑(PA)是一种常见现象,与多种负面的患者结局相关。缓解PA被视为一种护理标准,但它的应用并不普遍,且常常被忽视。本调查旨在评估全国范围内麻醉医生对于缓解儿童PA的当前实践模式和态度。

材料与方法

设计了一份包含25个问题的问卷,内容包括缓解儿童PA的方法、不依从的原因以及相关并发症。通过谷歌表单在线调查并手动分发给印度麻醉医师协会的成员。

结果

共调查了450名麻醉医生。回复主要来自全国各地医学院校的麻醉医生。尽管97%的被调查者采用了焦虑缓解策略,但只有37%的人始终如一地使用。73%的麻醉医生同时采用了药理学和非药理学技术。避免术前用药的最常见原因是预计气道困难(88%)。镇静不足是一个普遍报告的问题。95%的参与者认为缓解PA的策略应成为儿科麻醉实践的一部分。不遵循这些做法的最常见原因是医院基础设施不足(67%)。97%的参与者认为需要提高对这一关键围手术期问题的认识。

结论

只有37%的被调查麻醉医生始终如一地使用某种形式的PA缓解策略,且实践差异很大。需要进一步改进并采用涉及麻醉医生、外科医生和护士的团队方法,以确保儿科PA缓解服务的质量,并将其确立为护理标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5eb8/10760609/5311e1514222/JIAPS-28-479-g001.jpg

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