非药物措施改善手术患儿麻醉诱导配合度的最佳证据总结

Summary of the best evidence for non-pharmacological interventions to improve anesthesia induction coordination in children undergoing surgery

目的检索、评价并总结非药物措施改善手术患儿麻醉诱导配合度的最佳证据,为临床实践提供循证依据。方法按照“6S”证据模型,系统检索UpToDate、Cochrane Library、PubMed、医脉通指南网等国内外指南网及数据库。纳入涉及非药物措施改善手术患儿麻醉诱导配合度的所有证据,包括指南、系统评价、证据总结、专家共识,检索时限为建库至2021年10月1日。由研究者根据相关文献质量评价标准对文献进行独立质量评价,并结合专业判断对最终纳入文献进行标准化的资料提取。结果共纳入文献15篇,其中,7篇指南、7篇系统评价、1篇专家共识,包括术前健康教育、手术室环境设置、分散注意力技术、社会干预、呼吸面罩使用5个方面,共提取20条最佳证据。结论该研究总结了非药物措施改善手术患儿麻醉诱导配合度的最佳证据,非药物疗法对于护士而言安全性高且可操作性强,临床医护人员可结合临床情境及科室具体政策将证据进行临床转化和应用,以提高手术患儿麻醉诱导的配合度。

Objective To search,evaluate,and summarize the best evidence of non-pharmacological interventions to improve cooperation during anesthesia induction in children undergoing surgery,providing evidence-based evidence for clinical practice.Methods According to the“6S”evidence resource pyramid model,the domestic and foreign guide networks and databases including UpToDate,Cochrane Library,PubMed and Yimai Tong Guide were systematically searched.All the evidence of non-pharmacological interventions to improve anesthesia induction coordination in children undergoing surgery was involved,including guidelines,systematic reviews,evidence summaries,and expert consensuses.The retrieval time limit was from the establishment of the database to October 1,2021.Researchers conducted independent quality evaluation of the literature according to the relevant literature quality evaluation criteria,and they standardized data extraction of the final included literature based on professional judgment.Results Totally 15 pieces of the literature were included,including 7 clinical practice guidelines,7 systematic reviews and 1 expert consensus.Finally,20 pieces of best evidence about preoperative education,operating room environment setting,distraction technology,social intervention and the use of breathing masks were summarized.Conclusion The study summarizes the best evidence of non-pharmacological interventions to improve the anesthesia induction cooperation in children with surgery.Non-pharmacological interventions have high safety and operability for nurses,and clinical medical staff can combine the clinical situation and specific policies to carry out the evidence for clinical transformation and application,so as to improve the degree of anesthesia induction cooperation in surgical children.