Wang Yue, Wang Lifang, Liang Nan, Wang Kan
China-Japan Friendship Hospital, Department of Anesthesiology, Beijing, China.
China-Japan Friendship Hospital, Department of Anesthesiology, Beijing, China.
J Pediatr (Rio J). 2025 Jan-Feb;101(1):21-29. doi: 10.1016/j.jped.2024.06.016. Epub 2024 Sep 6.
Emergence delirium is frequently observed in pediatric patients. With advancements in video-based interventions, such as cartoons, video games, and virtual reality, these modalities may contribute to a reduced incidence of emergency delirium among children. However, robust evidence supporting their efficacy remains necessary.
The authors conducted a systematic search across multiple databases, including Embase, MEDLINE, and Cochrane Library, to identify all randomized controlled trials comparing video-based interventions with control treatments in pediatric emergence delirium. Data were aggregated and analyzed using Review Manager 5.4 to evaluate the effectiveness of video-based interventions.
The analysis included eight randomized controlled trials comprising 872 children. The intervention group showed a trend toward lower Pediatric Anesthesia Emergence Delirium scores (p = 0.10) and fewer emergence delirium events (p = 0.52). Seven studies demonstrated that video-based interventions significantly reduced preoperative anxiety, as indicated by decreased scores on the modified Yale Pre-operative Anxiety Scale (p < 0.00001). Anesthesia duration did not significantly differ between the intervention and control groups (p = 0.16). Notably, subgroup analyses revealed a significant reduction in Pediatric Anesthesia Emergence Delirium scores among children under seven years of age (p = 0.001).
Video-based interventions were linked to lower Pediatric Anesthesia Emergence Delirium scores and a decreased incidence of emergence delirium events. However, these results did not reach statistical significance across the broader sample. Notably, in children under seven, these interventions significantly reduced the scores.
III.
小儿患者中经常出现苏醒期谵妄。随着基于视频的干预措施（如卡通片、电子游戏和虚拟现实）的发展，这些方式可能有助于降低儿童苏醒期谵妄的发生率。然而，仍需要有力证据支持其有效性。
作者对多个数据库进行了系统检索，包括Embase、MEDLINE和Cochrane图书馆，以确定所有比较基于视频的干预措施与小儿苏醒期谵妄对照治疗的随机对照试验。使用Review Manager 5.4汇总和分析数据，以评估基于视频的干预措施的有效性。
分析纳入了八项随机对照试验，共872名儿童。干预组的小儿麻醉苏醒期谵妄评分有降低趋势（p = 0.10），苏醒期谵妄事件较少（p = 0.52）。七项研究表明，基于视频的干预措施显著降低了术前焦虑，改良耶鲁术前焦虑量表评分降低表明了这一点（p < 0.00001）。干预组和对照组之间的麻醉持续时间无显著差异（p = 0.16）。值得注意的是，亚组分析显示，七岁以下儿童的小儿麻醉苏醒期谵妄评分显著降低（p = 0.001）。
基于视频的干预措施与较低的小儿麻醉苏醒期谵妄评分和苏醒期谵妄事件发生率降低有关。然而，在更广泛的样本中，这些结果未达到统计学意义。值得注意的是，在七岁以下儿童中，这些干预措施显著降低了评分。
III级。
