音乐治疗在儿童全麻下行扁桃体/腺样体切除术后苏醒期的应用  

Application of music therapy on awakening from general anesthesia after pediatric adenotonsillectomy

作　　者：胡逸非 王硕[2] 周加慧 宋海成 张旭[1] 任悦义[3] Hu Yifei;Wang Shuo;Zhou Jiahui;Song Haicheng;Zhang Xu;Ren Yueyi(Department of Heart Center,Qingdao Women and Children′s Hospital Affiliated to Qingdao University,Qingdao 266034,China;Labor Union,Qingdao Women and Children′s Hospital Affiliated to Qingdao University,Qingdao 266034,China;Department of Endoscopy Center,Qingdao Women and Children′s Hospital Affiliated to Qingdao University,Qingdao 266034,China)

机构地区：[1]青岛大学附属妇女儿童医院心脏中心,青岛266034 [2]青岛大学附属妇女儿童医院工会,青岛266034 [3]青岛大学附属妇女儿童医院内镜中心,青岛266034

出　　处：《国际麻醉学与复苏杂志》2024年第7期736-740,共5页International Journal of Anesthesiology and Resuscitation

摘　　要：目的评价音乐治疗在患儿全麻扁桃体/腺样体切除术后苏醒期的应用效果。方法择期行低温等离子扁桃体/腺样体切除术的患儿240例,性别不限,年龄3~10岁,按随机数字表法分为3组(每组80例):原创音乐组(O组)、自选音乐组(P组)和对照组(C组)。3组患儿麻醉相同的基础上,O组播放研究者原创编写制作的功能性音乐,P组播放患儿根据自己偏好事先选择的音乐,C组播放无声音轨。记录3组患儿苏醒期谵妄(ED)发生率、FLACC评分、术后恶心呕吐(PONV)发生率,术后24 h内再出血发生率,苏醒时间,护士满意度及患儿家属满意度;记录3组患儿麻醉诱导前(T_(0))、手术结束时(T_(1))、收听音轨5 min后(T_(2))、拔管时(T_(3))、拔管后5 min(T_(4))时的心率、平均动脉压(MAP)、脉搏血氧饱和度(SpO_(2))。结果C组苏醒期ED发生率高于O组(P<0.05)。P组、C组苏醒期FLACC评分高于O组(均P<0.05),C组苏醒期FLACC评分高于P组(P<0.05)。P组、C组护士满意度低于O组(均P<0.05),C组护士满意度低于P组(P<0.05);C组患儿家属满意度低于O组、P组(均P<0.05)。T_(2)、T_(4)时C组心率高于O组、P组(均P<0.05);T_(4)时P组、C组MAP高于O组(均P<0.05),C组MAP高于P组(P<0.05)。3组患儿其余指标差异无统计学意义(均P>0.05)。结论音乐治疗用于患儿扁桃体/腺样体切除术后苏醒期,有助于降低苏醒期ED发生率,减轻术后疼痛,并能维持血流动力学稳定,提高患儿家属满意度和护士满意度;宫调原创音乐应用于该人群具有一定的优势。Objective To evaluate the effect of music therapy in the awakening period after tonsil/adenoidectomy under general anesthesia in children.Methods A total of 240 children,boys or girls,aged 3-10 years old,who underwent elective low-temperature plasma tonsil/adenoidectomy were selected.According to the random number table method,they were divided into three groups(n=80):an original music group(group O),a self-selected music group(group P),and a control group(group C).Based on the same anesthetic regimen in the three groups,group O played the functional music originally written and produced by the researcher,group P played the music pre-selected by the children based on their own preference,and group C played a silent track.The incidence of emergence delirium(ED),the Face,Legs,Activity,Cry and Consolability(FLACC)scores,the incidence of postoperative nausea and vomiting(PONV),the incidence of rebleeding within 24 h after surgery,awakening time,nurses'satisfaction,and the satisfaction of the children's family members were recorded in the three groups.The heart rate,mean arterial pressure(MAP),and pulse oxygen saturation(SpO_(2))before anesthesia induction(T_(0)),at the end of surgery(T_(1)),5 min after listening to the audio track(T_(2)),at the time of extubation(T_(3)),and 5 min after extubation(T_(4))were recorded.Results Compared with group O,the incidence of ED in group group C was higher(P<0.05).Compared with group O,the incidence of ED and FLACC score in group P and group C were higher(all P<0.05).Compared with group P,the incidence of FLACC score in group C was higher(P<0.05).The satisfaction of nurses was lower in groups P and C than in group O(all P<0.05),and the satisfaction of nurses was lower in group C than in group P(all P<0.05).The satisfaction of family members of the children was lower in group C than in groups O and P(all P<0.05).The heart rate of group C was higher than those of group O and group P at T_(2) and T_(4)(all P<0.05).The MAP of group P and group C was higher than that of group O at T_(4

关 键 词：音乐治疗 五音疗法 儿童 麻醉 全身 扁桃体/腺样体切除术 

分 类 号：R726.1[医药卫生—儿科]