The Use of Preoperative Video Distraction on Emergence Delirium in Preschool Children Undergoing Strabismus Surgery Under Anesthesia with Sevoflurane: A Randomized Controlled Trial

IF 2.8 3区医学 Q1 Pharmacology, Toxicology and Pharmaceutics

Therapeutics and Clinical Risk Management Pub Date : 2024-03-22 DOI:10.2147/tcrm.s447419

Yue Wang, Liyan Chu, He Li, Yingjie Du, Shanshan Wang, Ying Liu, Guyan Wang

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Abstract

Purpose: The aim of this study was to determine whether preoperative video distraction reduces the incidence of emergence delirium in preschool children under general anesthesia with sevoflurane.
Patients and Methods: In this prospective randomized controlled study, children aged 3– 6 years were randomized to receive either video distraction (Group V) or common clinical practice (Group C) from arrival at the holding area to induction of anesthesia. The primary outcome was the incidence of emergence delirium. Preoperative anxiety scores, assessed by the simple modified Yale Perioperative Anxiety Scale, were also collected.
Results: A total of 160 patients were included in our study. The children in Group V (n=80) exhibited a significantly lower incidence of emergence delirium than did those in Group C (n=80) (12.5% vs 35.0%; RR 0.36, 95% CI 0.19, 0.69; P =0.0008). The maximum Pediatric Anesthesia Emergence Delirium score in Group V was significantly lower than that in Group C (3.0 vs 5.0; mean difference − 2.64, 95% CI: − 4.12, − 1.16; P=0.0003). The simple modified Yale Perioperative Anxiety Scale scores at separation from parents and the onset of inhalation induction in Group V were significantly lower than those in Group C (36.4 ± 9.9 vs 48.2 ± 16.7; mean difference 11.92, 95% CI 7.25, 16.59; P< 0.0001 and 41.5 ± 15.9 vs 59.7 ± 21.5; mean difference 18.11, 95% CI 11.76, 24.47; P< 0.0001).
Conclusion: Preoperative video distraction reduces the incidence of emergence delirium in preschool children who undergo strabismus surgery under general anesthesia with sevoflurane.

Keywords: emergence delirium, anxiety, children, preschool

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使用七氟醚麻醉下进行斜视手术的学龄前儿童术前视频分散对谵妄的影响：随机对照试验

目的：本研究旨在确定术前视频分散注意力是否能降低使用七氟醚进行全身麻醉的学龄前儿童出现谵妄的发生率：在这项前瞻性随机对照研究中，3-6 岁的儿童被随机分为两组，分别接受视频分散注意力（V 组）或普通临床实践（C 组），时间均为从到达留观区到麻醉诱导的整个过程。主要结果是出现谵妄的发生率。此外，还收集了术前焦虑评分，采用简单的改良耶鲁围术期焦虑量表进行评估：我们的研究共纳入了 160 名患者。第五组（80 名）患儿的谵妄发生率明显低于 C 组（80 名）（12.5% vs 35.0%; RR 0.36, 95% CI 0.19, 0.69; P =0.0008）。第五组小儿麻醉后谵妄的最高评分明显低于 C 组（3.0 vs 5.0；平均差 - 2.64，95% CI：- 4.12，- 1.16；P=0.0003）。第五组在与父母分离和开始吸入诱导时的简易修正耶鲁围术期焦虑量表评分显著低于 C 组（36.4 ± 9.9 vs 48.2 ± 16.7；平均差 11.92，95% CI 7.25，16.59；P<；0.0001 和 41.5 ± 15.9 vs 59.7 ± 21.5；平均差 18.11，95% CI 11.76，24.47；P<；0.0001）：术前视频分散可降低在七氟醚全身麻醉下接受斜视手术的学龄前儿童出现谵妄的发生率。

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来源期刊

Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-

CiteScore

5.30

自引率

3.60%

发文量

139

审稿时长

16 weeks

期刊介绍： Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.