父母陪伴式麻醉诱导对学龄前手术患儿术前焦虑及麻醉诱导配合度的影响

Effect of Parental Presence during Induction of Anesthesia on Preoperative Anxiety and Compliance of Anesthesia Induction in Preschool Children

目的探讨父母陪伴式麻醉诱导对学龄前手术患儿术前焦虑及麻醉诱导配合度的影响。方法采用历史对照设计匹配纳入武汉市某三级甲等医院进行手术治疗的101例患儿为研究对象,其中陪伴组50例和对照组51例。陪伴组进行父母陪伴式麻醉诱导,包括父母术前麻醉诱导陪伴宣教和家庭参与式陪伴;对照组按常规由医护人员抚慰患儿。采用协方差分析比较2组手术当日在术前等待间10 min(T1)和麻醉诱导时(T2)时的焦虑水平及T2时麻醉诱导配合程度。结果 2组患儿的基线特征除了手术台次外均具有可比性,在T1时刻,2组焦虑均上升,2组调整前、调整后差异均无统计意义(P>0.05)。在T2时刻,2组焦虑进一步上升,组间调整后差异为11.03(95%CI:2.06~20.00),差异有统计意义(P=0.02)。陪伴组在T2时麻醉诱导得分为1.04,对照组2.09,调整后差异为0.96(95%CI:0.12~1.78,P=0.03)。结论父母陪伴式麻醉诱导可降低学龄前手术患儿的术前焦虑,提高手术患儿麻醉诱导合作度,可为下一步构建标准化父母陪伴式麻醉诱导方案提供依据。

Objective To explore the effect of parent presence at the induction of anesthesia(PPIA)on relieving preoperative anxiety and improving compliance of anesthesia induction in preschool children.Methods A total of 101 children who underwent surgical treatment in a tertiary grade A hospital in Wuhan were selected by historical control design,including 50 patients in the companion group and 51 patients in the control group.The companion group adopted PPIA,in which parents were educated with preoperative anesthesia-induced companionship and family-participation.Participants in the control group were comforted by medical staff.Analysis of covariance was used to compare the anxiety at 10 minutes before the operation(T1)and during anesthesia induction(T2)and cooperation for anesthesia induction(T2)between the two groups.Results The baseline characteristics of the two groups were comparable except for the operating sequence.At T1,the anxiety of both groups increased significantly.There was no statistical difference between the two groups before and after the adjustment(P>0.05).At T2,the anxiety of the two groups increased and the adjusted difference between the two groups was 11.03(95%confidence interval:2.06,20.00)with statistical significance(P=0.02).Level of cooperation for anesthesia induction was 1.04 in companion group and 2.09 in the control group and the adjusted difference was 0.96(95%confidence interval:0.12,1.78,P=0.03).Conclusion PPIA is effective for reducing preoperative anxiety and improving the level of cooperation in anesthesia induction in preschool children.The present study provides basis to construct a standardized PPIA program.