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根据唾液皮质醇和改良耶鲁术前焦虑量表评估父母陪伴对儿童术前应激的影响:半随机试验

Children's preoperative stress according to the parental presence evaluated by salivary cortisol and mYPAS: quasi-randomized trial.

作者信息

Silveira Ketillyn Nayara de Macedo, Alves Rodrigo Leal, Nascimento Júnior Paulo do, Coelho Monique Antonia, Barros Guilherme Antonio Moreira de, Módolo Norma Sueli Pinheiro

机构信息

Universidade Estadual Paulista, Botucatu, SP, Brasil.

出版信息

Rev Esc Enferm USP. 2024 Mar 8;58:e20230232. doi: 10.1590/1980-220X-REEUSP-2023-0232en. eCollection 2024.

Abstract

OBJECTIVE

The main objective of this study was to compare stress and anxiety levels in children undergoing surgical procedures with or without parental presence at induction of anesthesia by measuring salivary cortisol levels and applying the mYPAS.

METHOD

Quasi-randomized trial with children aged 5-12 year, with ASA physical status I, II, or III, undergoing elective surgery. According to parents' willingness, the pair were defined as accompanied or unaccompanied group. Chi-square, Fisher's exact tests, Student's t test, Mann-Whitney, Hodges-Lehman and Spearman's tests were used for statistical analyzes.

RESULTS

We included 46 children; 63% were preschool children mostly accompanied by their mothers (80%). The median mYPAS score was 37.5 (quartile range, 23.4-51.6) in unaccompanied children, and 55.0 (quartile range, 27.9-65.0) in accompanied children, with an estimated median difference of +11.8 (95% CI of 0 to 23.4; p = 0.044). There were no significant differences in the mean salivary cortisol levels.

CONCLUSION

The level of anxiety was higher in accompanied children. There were no differences in salivary cortisol levels between both groups. Brazilian Registry of Clinical Trials (ReBEC): RBR-9wj4qvy.

摘要

目的

本研究的主要目的是通过测量唾液皮质醇水平并应用儿童耶鲁术前焦虑量表(mYPAS),比较在麻醉诱导时有无父母陪伴的手术患儿的压力和焦虑水平。

方法

对年龄在5至12岁、美国麻醉医师协会(ASA)身体状况分级为I、II或III级的择期手术患儿进行半随机试验。根据父母的意愿,将患儿分为有陪伴组和无陪伴组。采用卡方检验、Fisher精确检验、学生t检验、曼-惠特尼检验、霍奇斯-莱曼检验和斯皮尔曼检验进行统计分析。

结果

我们纳入了46名儿童;63%为学龄前儿童,大多数由母亲陪伴(80%)。无陪伴儿童的mYPAS评分中位数为37.5(四分位间距,23.4 - 51.6),有陪伴儿童为55.0(四分位间距,27.9 - 65.0),估计中位数差异为 +11.8(95%置信区间为0至23.4;p = 0.044)。两组唾液皮质醇平均水平无显著差异。

结论

有陪伴儿童的焦虑水平更高。两组唾液皮质醇水平无差异。巴西临床试验注册中心(ReBEC):RBR - 9wj4qvy。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49a6/10927269/180a36c7b6b1/1980-220X-reeusp-58-e20230232-gf01.jpg

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