卡通视频辅助的术前访视对学龄前患儿术后不适应性行为的影响

Effect of cartoon video-assisted preoperative interview on postoperative maladaptive behaviors of preschool pediatric patients

目的 探讨卡通视频辅助的术前访视对学龄前患儿术后不适应性行为的影响.方法 选择择期行斜视矫正术患儿100例,年龄3～6岁,体重12～28 kg,ASA分级Ⅰ或Ⅱ级,采用随机数学表法分为2组（n=50）：卡通视频辅助的术前访视组（Ⅰ组）和常规术前访视组（Ⅱ组）.Ⅰ组访视时麻醉医生陪同患儿及其家属一起观看专门制作的介绍围术期流程的卡通视频,并解答患儿及其家属提出的问题.术中气管插管完成后,Ⅰ组经10 min静脉输注右美托咪定0.3 μg/kg,Ⅱ组经10 min静脉输注右美托咪定0.6 μg/kg.吸入3％ ～4％七氟醚维持麻醉.记录PACU期间躁动发生情况和程度,记录苏醒时间、PACU停留时间.术后1周进行行为量表评分,记录行为改变的发生情况.结果 与Ⅱ组比较,Ⅰ组苏醒期躁动发生率降低,程度减轻,苏醒时间和PACU停留时间缩短,术后行为改变发生率（4％）降低（P＜0.05）.结论 卡通视频辅助的术前访视可有效降低学龄前患儿术后不适应性行为的发生几率.

Objective To investigate the effect of cartoon video-assisted preoperative interview on the postoperative maladaptive behaviors of preschool pediatric patients.Methods One hundred preschool pediatric patients,aged 3-6 yr,weighing 12-28 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective strabismus surgery,were divided into 2 groups （n =50 each） using a random number table：cartoon video-assisted preoperative interview group （group Ⅰ） and routine preoperative interview group （group Ⅱ）.In group Ⅰ,accompanied by the anesthesiologist,children and their parents watched the cartoon video designed for the perioperative process,and the anesthesiologist answered the questions that their parents had.After completion of tracheal intubation,dexmedetomidine 0.3 and 0.6 μg/kg were infused intravenously over 10 min in group Ⅰ and group Ⅱ,respectively.Three percent-4% sevoflurane was inhaled to maintain anesthesia.The development and degree of agitation during stay in the post-anesthesia care unit （PACU） were recorded.The emergence time and length of PACU stay were also recorded.Postoperative maladaptive behaviors were assessed with the Post-Hospital Behavior Questionnaire at 1 week after surgery,and the occurrence of behavioral changes was recorded.Results Compared with group Ⅱ,the incidence of emergence agitation was significantly decreased,the degree of emergence agitation was reduced,the emergence time and length of PACU stay were shortened,and the incidence of behavioral changes （4%） was decreased after surgery in group Ⅰ （P〈0.05）.Conclusion Cartoon video-assisted preoperative interview can effectively decrease the development of postoperative maladaptive behaviors of the preschool pediatric patients.