母亲声音对全麻患儿苏醒期谵妄的影响

Effect of mother's voice on delirium during recovery in children under general anesthesia

目的探究母亲声音对全麻患儿苏醒期谵妄发生情况的影响。方法选取2018年2月至2019年2月于广州市妇女儿童医疗中心进行全麻诱导手术的患儿198例,并按照随机数字表法分为对照组、观察组,各99例。对照组患儿常规进行手术,观察组患儿围术期通过播放母亲声音的方式进行干预,直至患儿意识清醒、看见母亲。对两组患儿手术质量进行评价,使用改良耶鲁术前焦虑分级评分量表(m-YPAS)对两组患儿术前焦虑情况进行评价,使用诱导共同合作度量表(ICC)对两组患儿术前麻醉诱导期依从情况、合作情况进行评价,使用康奈尔儿童谵妄量表(CAPD)对两组患儿苏醒期谵妄情况进行评价,使用改良加拿大东安大略儿童医院疼痛评分量表(m-CHEOPS)对两组患儿疼痛情况进行评价,对两组患儿术后苏醒时间以及意识清醒时间进行比较,对两组患儿苏醒期谵妄发生情况以及术后谵妄发生情况进行统计,以问卷调查形式统计患者家属满意情况。结果两组患儿手术质量总分比较差异无统计学意义(P>0.05);观察组患儿术前焦虑评分显著短于对照组,差异有统计学意义(P<0.05);两组患儿诱导期ICC评分对比,差异无统计学意义(P>0.05);两组患儿手术时间对比,差异无统计学意义(P>0.05);观察组患儿CAPD评分显著短于对照组,差异有统计学意义(P<0.05)。观察组患儿苏醒时间显著短于对照组,差异有统计学意义(P<0.05);观察组患儿意识清醒时间显著短于对照组,差异有统计学意义(P<0.05);观察组患儿m-CHEOPS评分显著低于对照组,差异有统计学意义(P<0.05)。观察组患儿苏醒期谵妄发生率、术后谵妄发生率显著低于对照组,差异有统计学意义(P<0.05)。观察组患儿家属总满意率显著高于对照组,差异有统计学意义(P<0.05)。结论通过播放母亲声音对进行全麻诱导手术的患儿进行干预,能够促进患儿苏醒以及意识清醒,减轻患儿痛苦,降低苏醒期谵妄以及术后谵妄发生率,使患儿家属更加满意。

Objective To explore the influence of mother's voice on delirium in recovery period of general anesthesia children.Methods A total of 198 cases of children undergoing general anesthesia induction operation in this hospital from February 2018 to February 2019 were selected and divided into control group and observation group according to random number table method,99 cases in each group.The children in the control group received routine surgery,while the children in the observation group were intervened by playing the mother's voice during the perioperative period until the children were conscious and saw their mother.The operation quality of the two groups was evaluated.The Modified Yale Preoperative Anxiety Rating Scale(m-YPAS)was used to evaluate preoperative anxiety in both groups.The Induced Co-cooperation Scale(ICC)was used to evaluate the compliance and cooperation during the induction period of preoperative anesthesia in the two groups.The Cornell Assessment of Pediatric Delirium(CAPD)was used to evaluate the onset delirium in both groups.The Modified Children's Hospital of Eastern Ontario Pain Scale(m-CHEOPS)was used to evaluate pain in both groups.The postoperative awakening time and conscious waking time of the two groups were compared.The incidence of delirium during awakening period and postoperative delirium in the two groups were statistically analyzed.The satisfaction of the patients'family members was statistically analyzed in the form of questionnaire survey.Results There was no significant difference in the total score of operation quality between the two groups(P>0.05);the preoperative anxiety score of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05);there was no significant difference in ICC score between the two groups during induction period(P>0.05);there was no significant difference in operation time between the two groups(P>0.05).The CAPD score in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The recovery time of the observation group was significantly shorter than that of the control group,and the difference was statistically significant(P<0.05);the awakening time of the observation group was significantly shorter than that of the control group,and the difference was statistically significant(P<0.05);the m-CHEOPS score of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The incidence of delirium during awakening period and postoperative delirium was significantly lower than that in control group,and the difference was statistically significant(P<0.05).The total satisfaction rate of the family members in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusions Intervention of children undergoing general anesthesia induction operation by playing mother's voice can promote the recovery and consciousness of children,alleviate the pain of children,reduce the incidence of delirium during awakening and delirium after operation,and make the family members of children more satisfied.