College of Nursing, Jeonbuk National University, Jeonju-si, Jeollabuk-do, Republic of Korea; Research Institute of Nursing Science, Jeonbuk National University, Jeonju-si, Jeollabuk-do, Republic of Korea; Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju-si, Jeollabuk-do, Republic of Korea.
College of Nursing, Jeonbuk National University, Jeonju-si, Jeollabuk-do, Republic of Korea; Research Institute of Nursing Science, Jeonbuk National University, Jeonju-si, Jeollabuk-do, Republic of Korea; Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju-si, Jeollabuk-do, Republic of Korea.
J Perianesth Nurs. 2024 Jun;39(3):475-483. doi: 10.1016/j.jopan.2023.10.002. Epub 2024 Jan 12.
This study reviewed existing literature on parental presence in cases of pediatric patients after general anesthesia and explored its effect on emergence delirium (ED) in the postanesthesia care unit (PACU).
Systematic review and meta-analysis.
After protocol registration, we searched the PubMed, EMBASE, CINHAL, Web of Science, SCOPUS, and CENTRAL databases. Two authors independently searched and selected the relevant studies, assessed their risk of bias, and abstracted the data. The primary outcome was ED, and the additional outcome was pain. We provided the narrative synthesis and meta-analysis results.
Of the 296 articles retrieved, 6 were included in the narrative synthesis, and 5 were used for the meta-analysis. Four studies were randomized controlled trials, and two studies were nonrandomized controlled trials. There were 348 pediatric patients in the parental presence group and 314 pediatric patients in the usual care group. Parental presence effectively reduced the ED score (mean difference, -0.58; 95% confidence interval [CI], -0.84 to -0.31; P < .001). The ED incidence rate (log odds ratio, -0.58; 95% CI, -1.24 to 0.09; P = .090) and pain score (standardized mean difference, -0.24; 95% CI, -0.57 to 0.10; P = .163) were lower in the parental presence group than in the usual care group. However, the differences were not statistically significant.
The presence of parents in the PACU can reduce ED in pediatric patients. Therefore, parental presence may be a useful intervention in the PACU.
本研究回顾了全麻后儿科患者家长陪伴的现有文献，并探讨了其对麻醉后恢复室（PACU）中苏醒期谵妄（ED）的影响。
系统评价和荟萃分析。
方案注册后，我们检索了 PubMed、EMBASE、CINHAL、Web of Science、SCOPUS 和 CENTRAL 数据库。两位作者独立检索并选择了相关研究，评估了其偏倚风险，并提取了数据。主要结局为 ED，次要结局为疼痛。我们提供了叙述性综述和荟萃分析结果。
在检索到的 296 篇文章中，有 6 篇纳入了叙述性综述，有 5 篇用于荟萃分析。4 项研究为随机对照试验，2 项研究为非随机对照试验。家长陪伴组有 348 例儿科患者，常规护理组有 314 例儿科患者。家长陪伴可有效降低 ED 评分（平均差，-0.58；95%置信区间[CI]，-0.84 至 -0.31；P<.001）。ED 发生率（对数优势比，-0.58；95%CI，-1.24 至 0.09；P=0.090）和疼痛评分（标准化均数差，-0.24；95%CI，-0.57 至 0.10；P=0.163）在家长陪伴组均低于常规护理组，但差异无统计学意义。
PACU 中家长的陪伴可以降低儿科患者的 ED 发生率。因此，家长陪伴可能是 PACU 中一种有用的干预措施。
