麻醉诱导过程中母亲的存在对扁桃体切除术和/或腺样体切除术儿童唾液皮质醇水平的影响。

H. Ozdogan, S. Çetinalp, G. Kuran, O. Tuğal, Murat Tahiroglu, Ummuhan E. Herdem, Süheyl Haytoğlu
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引用次数: 18

摘要

目的:虽然在麻醉诱导过程中父母的存在被认为可以降低儿童手术应激水平,但关于这一策略的结果却相互矛盾。本研究的目的是通过测定唾液皮质醇水平来评估诱导过程中母亲的存在对扁桃体切除术和/或腺样体切除术儿童手术应激水平的影响。设计:非随机临床研究。术前、术后恢复室、手术室。患者:该研究包括48名年龄在5-12岁之间的儿童,他们接受了扁桃体切除术和/或腺样体切除术。干预措施将患者分为两组。第一组的孩子在准备室与他们的母亲分开。第二组患儿与母亲在一起直至麻醉诱导。测量方法术前对母子进行状态-特质焦虑量表(STAI)。在4个不同的时间段评估唾液皮质醇水平:1)准备室,2)麻醉诱导后,3)手术第30分钟,4)术后恢复室。主要结果两组患者人口学特征、手术及麻醉时间差异无统计学意义。儿童或母亲的术前焦虑评分在两组之间没有差异。诱导后和恢复室1组唾液皮质醇水平显著高于2组(p: 0.001和p: 0.02)。结论:在麻醉诱导和产妇在场恢复期间,唾液皮质醇水平下降,表明这些时期的应激减轻。需要进一步的研究来确定父母在场对麻醉诱导的影响,特别是对手术结果的影响。
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The effects of maternal presence during anesthesia induction on salivary cortisol levels in children undergoing tonsillectomy and/or adenoidectomy.
OBJECTIVE Although parental presence during anesthesia induction is suggested to diminish operative stress level in children, there have been conflicting results about this strategy. The aim of this study was to evaluate the effects of maternal presence during induction on operative stress level in children who had tonsillectomy and/or adenoidectomy by determining the salivary cortisol levels. DESIGN Non-randomized clinical study. SETTING Preoperative and postoperative recovery rooms, operating room. PATIENTS The study included 48 children between the ages of 5-12years who underwent tonsillectomy and/or adenoidectomy. INTERVENTIONS The patients were divided into 2 groups. The children in group 1 were separated from their mothers at the preparation room. The children in group 2 stayed together with their mothers till the anesthesia induction. MEASUREMENTS State Trait Anxiety Inventory (STAI) was performed to the mothers and children preoperatively. Salivary cortisol levels were evaluated in 4 different time frames: 1) in preparation room, 2) after anesthesia induction, 3) at the 30th minute of operation, and 4) in postoperative recovery room. MAIN RESULTS There were no statistically significant differences between groups regarding demographic features, and operation or anesthesia times. The child's or mothers' preoperative anxiety scores were not different between the groups. Salivary cortisol levels in group 1 were significantly increased after induction and in recovery room compared to those in group 2 (p: 0.001, and p: 0.02, respectively). CONCLUSIONS We have determined decreased salivary cortisol levels during anesthesia induction and recovery in the maternal presence revealing diminished stress in these periods. Further studies are warranted to determine the effects of parental presence during anesthesia induction especially on surgical outcomes.
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