Clinical Study Of Video Call Between Mother And Child To Reduce Emergence Delirium In Pediatric Patient After General Anesthesia

Objective: During recovering in Postanesthesia Care Unit(PACU),is it possible to reduce the incidence and severity of emergence delirium and agitation if pediatric patients after general anesthesia can have a real-time video call with their mother,while the mother performing part of the awaking and comfort work?Methods:After obtaining the consent of the Ethics Committee of the Affiliated Hospital of Yan’an University,we select 80 pediatric patients with tonsillectomy and adenoidectomy under general anesthesia in our hospital from January 2020 to January 2021,ASA I,aged from 4 to 12,according to the random number table,80 children who met the inclusion criteria were randomly divided into two groups as video call group(group S)and regular recover group(group C),40 cases in each group.Anesthesiologist A,who didn’t know the details of grouping,assessing the anxiety of score of these children according to the m-YPAS standard before the anesthesia started.The premedicate,anesthetic induction and maintenance medication of both group are the same.All the medications were stopped when the operation was finished.Heart rate(HR)and mean arterial pressure(MAP)were recorded before induction(t1),during intubation(t2),at the beginning of surgery(t3)and at the end of surgery(t4).We would wait our pediatric patients to revive without any stimulation after they were transferred in to the PACU.After the endotracheal tube was removed,children in Group S started the video call with their mom within 1 minute while children in Group C had a normal revive process according to our PACU workflow with a same medical officer’s comfort.Both groups of children were transferred to the general ward after meeting the standard of exiting from PACU.At the time 1 minute(P0),5 minute(P1),10 minutes(P2),15 minutes(P3),20 minutes(P4),25 minutes(P5),30 minutes(P6)after the endotracheal tube was removed,PAED score was assessed at these time points by anesthesiologist C,the CHIPPS pain score was assessed by the same person after the endotracheal tube was removed.The HR and MAP were recorded at the time the endotracheal tube was removed(T0)and 1minute(T1),3 minutes(T2),5 minutes(T3),10minutes(T4),20 minutes(T5),30 minutes(T6)after the endotracheal tube was removed as well the time our pediatric patients were transferred into PACU(t5).We diagnosed ED if PAED score >12 and 1mg/kg propofol should be used by vein for treatment,0.1μg/kg sufentanil should be used depending on the circumstances if the CHIPPS score>3.When the analgesia pump was recycled on the second day after surgery,mothers of the two groups were asked to evaluate their satisfaction with the anesthetic process.Result: 1.The general situation comparison between group C and S,including age,height,weight and m-YPAS score,had no statistical significance(P>0.05).2.The comparison of HR and MAP between two groups at t1,t2,t3 and t4 had no statistical significance(P>0.05).3.The comparison of incidence of ED between two groups after the endotracheal tube was removed had statistical significance(P<0.05)and group C> group S.The comparison of PAED score between two groups at each time point had statistical significance(P<0.05)and group C> group S.4.After the endotracheal tube was removed,the comparison of CHIPPS score between two groups had no statistical significances(P>0.05).5.The comparison of the pediatric patients’ HR and MAP in the PACU showed that the difference of MAP had no statistical significances(P>0.05),the difference of HR at T0,T1,T2 had no statistical significances(P>0.05),but when the comparison had be done at T3,T4,T5,T6 the HR had statistical significances(P<0.05)and group C> group S.6.The comparison of the durations,which concluded the whole anesthetic progress and from the end of the anesthesia to the endotracheal tube was removed between two groups had no statistical significances,but the comparison of the duration of the staying in the PACU between two groups showed that difference had the statistical significance(P<0.05)and group C spent more time staying in the PACU than group S.7.The comparison of the mothers’ satisfaction evaluation between two groups had the statistical significance(P<0.05)and mothers in group C were more satisfied with the anesthetic experiences than the mothers in group S.Conclusion: Pediatric patients under general anesthesia had a real-time video call with their mom in the recovery period after the endotracheal tube was removed,could reduce the incidence and severity of ED,improve the mothers’ satisfaction with anesthesia,stabilize the heart rate and blood pressure of pediatric patients and reduce the staying time in the PACU.