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静态卡通与动态虚拟环境对学龄前手术患儿术前焦虑的影响。

Influence of static cartoons combined with dynamic virtual environments on preoperative anxiety of preschool-aged children undergoing surgery.

作者信息

Zhang Ya-Lin, Zhou Qi-Ying, Zhang Peng, Huang Lin-Feng, Jin Li, Zhou Zhi-Guo

机构信息

Department of Pediatrics, Hangzhou Ninth People's Hospital, Hangzhou 311225, Zhejiang Province, China.

Pediatric Intensive Care Unit, Hangzhou Children's Hospital, Hangzhou 310014, Zhejiang Province, China.

出版信息

World J Clin Cases. 2024 Aug 6;12(22):4947-4955. doi: 10.12998/wjcc.v12.i22.4947.

Abstract

BACKGROUND

Preschoolers become anxious when they are about to undergo anesthesia and surgery, warranting the development of more appropriate and effective interventions.

AIM

To explore the effect of static cartoons combined with dynamic virtual environments on preoperative anxiety and anesthesia induction compliance in preschool-aged children undergoing surgery.

METHODS

One hundred and sixteen preschool-aged children were selected and assigned to the drug ( = 37), intervention ( = 40), and control ( = 39) groups. All the children received routine preoperative checkups and nursing before being transferred to the preoperative preparation room on the day of the operation. The drug group received 0.5 mg/kg midazolam and the intervention group treatment consisting of static cartoons combined with dynamic virtual environments. The control group received no intervention. The modified Yale Preoperative Anxiety Scale was used to evaluate the children's anxiety level on the day before surgery (T0), before leaving the preoperative preparation room (T1), when entering the operating room (T2), and at anesthesia induction (T3). Compliance during anesthesia induction (T3) was evaluated using the Induction Compliance Checklist (ICC). Changes in mean arterial pressure (MAP), heart rate (HR), and respiratory rate (RR) were also recorded at each time point.

RESULTS

The anxiety scores of the three groups increased variously at T1 and T2. At T3, both the drug and intervention groups had similar anxiety scores, both of which were lower than those in the control group. At T1 and T2, MAP, HR, and RR of the three groups increased. The drug and control groups had significantly higher MAP and RR than the intervention group at T2. At T3, the MAP, HR, and RR of the drug group decreased and were significantly lower than those in the control group but were comparable to those in the intervention group. Both the drug and intervention groups had similar ICC scores and duration of anesthesia induction (T3), both of which were higher than those of the control group.

CONCLUSION

Combining static cartoons with dynamic virtual environments as effective as medication, specifically midazolam, in reducing preoperative anxiety and fear in preschool-aged children. This approach also improve their compliance during anesthesia induction and helped maintain their stable vital signs.

摘要

背景

学龄前儿童在即将接受麻醉和手术时会变得焦虑,因此需要开发更合适、有效的干预措施。

目的

探讨静态卡通片与动态虚拟环境相结合对学龄前手术患儿术前焦虑及麻醉诱导依从性的影响。

方法

选取116名学龄前儿童,分为药物组(n = 37)、干预组(n = 40)和对照组(n = 39)。所有儿童在手术当天被转移到术前准备室之前均接受常规术前检查和护理。药物组接受0.5mg/kg咪达唑仑,干预组接受静态卡通片与动态虚拟环境相结合的治疗。对照组不接受干预。采用改良耶鲁术前焦虑量表评估患儿在手术前一天(T0)、离开术前准备室前(T1)、进入手术室时(T2)和麻醉诱导时(T3)的焦虑水平。使用诱导依从性检查表(ICC)评估麻醉诱导(T3)期间的依从性。在每个时间点记录平均动脉压(MAP)、心率(HR)和呼吸频率(RR)的变化。

结果

三组患儿在T1和T2时焦虑评分均有不同程度升高。在T3时,药物组和干预组的焦虑评分相似,均低于对照组。在T1和T2时,三组患儿的MAP、HR和RR均升高。在T2时,药物组和对照组的MAP和RR显著高于干预组。在T3时,药物组的MAP、HR和RR下降,且显著低于对照组,但与干预组相当。药物组和干预组的ICC评分及麻醉诱导时间(T3)相似,均高于对照组。

结论

将静态卡通片与动态虚拟环境相结合在减轻学龄前儿童术前焦虑和恐惧方面与药物(特别是咪达唑仑)同样有效。这种方法还提高了他们在麻醉诱导期间的依从性,并有助于维持其生命体征稳定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4053/11238780/e35397d83bae/WJCC-12-4947-g001.jpg

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