Chen Hong, Chen Le, Zhu Chen, Li Sainan, Zhou Juan, Liu Chengxiang
Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, China.
Department of Pediatric Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, China.
J Perianesth Nurs. 2025 Apr;40(2):318-325. doi: 10.1016/j.jopan.2024.05.006. Epub 2024 Aug 14.
Emergence delirium (ED) presents challenges for both parents and health care providers in pediatric surgical settings. This study aims to evaluate the effectiveness of immersive virtual reality (VR) distraction and video distraction combined with parental presence in reducing ED in preschool-aged children undergoing elective surgery.
A prospective, randomized, controlled clinical trial was conducted with 90 children ages 4 to 7. Participants were randomly assigned to three groups: VR distraction (group V), tablet video distraction with parental presence (group T), and standard care (group C). The primary endpoints were the incidence of ED and Pediatric Anesthesia Emergence Delirium Scale scores, with secondary measures encompassing scores from the Parental Separation Anxiety Scale and the Faces, Legs, Activity, Cry, Consolability (FLACC) scale.
Participants were assigned to one of the three intervention groups, and relevant scales were used to assess ED, parental separation anxiety, and postoperative pain. The immersive VR distraction and video distraction with parental presence interventions were compared against standard care.
Immersive VR distraction significantly reduced the incidence of ED (6.67% in group V vs 40% in group T and 60% in group C), and the incidence of ED in group V was notably lower than in the other groups (P = .023 vs group T and P = .004 vs group C). Children in group V displayed significantly lower FLACC compared with the other groups as well (P < .05). However, no significant differences between the 3 groups were observed in perioperative anxiety as assessed by the Parental Separation Anxiety Scale scores (P = .27).
This study underscores the potential of immersive VR distraction as an effective intervention for mitigating ED in pediatric surgical patients. The findings suggest that incorporating VR technology during the perioperative period can positively impact postoperative outcomes. Further research in diverse surgical contexts is recommended to validate these findings and explore the broader applicability of VR distraction in pediatric health care settings.
在小儿外科手术环境中，苏醒期谵妄（ED）给家长和医护人员都带来了挑战。本研究旨在评估沉浸式虚拟现实（VR）分心干预和视频分心干预结合家长陪伴在减少择期手术学龄前儿童ED方面的有效性。
对90名4至7岁儿童进行了一项前瞻性、随机、对照临床试验。参与者被随机分为三组：VR分心干预组（V组）、有家长陪伴的平板视频分心干预组（T组）和标准护理组（C组）。主要终点是ED的发生率和小儿麻醉苏醒期谵妄量表评分，次要指标包括父母分离焦虑量表评分和面部、腿部、活动、哭闹、安慰度（FLACC）量表评分。
将参与者分配到三个干预组之一，使用相关量表评估ED、父母分离焦虑和术后疼痛。将沉浸式VR分心干预和有家长陪伴的视频分心干预与标准护理进行比较。
沉浸式VR分心干预显著降低了ED的发生率（V组为6.67%，T组为40%，C组为60%），V组的ED发生率明显低于其他组（与T组相比P = 0.023，与C组相比P = 0.004）。V组儿童的FLACC也明显低于其他组（P < .05）。然而，根据父母分离焦虑量表评分评估，三组在围手术期焦虑方面未观察到显著差异（P = 0.27）。
本研究强调了沉浸式VR分心干预作为减轻小儿外科手术患者ED的有效干预措施的潜力。研究结果表明，在围手术期引入VR技术可对术后结果产生积极影响。建议在不同的手术环境中进行进一步研究，以验证这些发现，并探索VR分心干预在小儿医疗保健环境中的更广泛适用性。
