Effect Of Recorded Maternal Voice On Recovery For General Anesthesia In Children:A Randomized Controlled Trial

Objective:1.To investigate the effects of recorded maternal voice on emergence agitation?EA?,pain,vital signs and stage time of recovery period of general anesthesia in children.To seek more simple,safe,effective and feasible clinical nursing intervention measures.2.To determine whether the recorded maternal voice is more advantageous than the stranger's voice in the care of children under general anesthesia.Methods:The subjects of this study were children aged 3-7 years who received elective pediatric or otolaryngological surgery in a third-grade hospital in Changchun with tracheal intubation general anesthesia from April to July2019,ASA I-II.By using envelope method,102 subjects were randomly divided into maternal recording group,stranger's recording group and control group?n=34?.The day before the operation,the mother's voice was recorded in a quiet environment.As the subject entered the post anaesthesia care unit?PACU?after surgery,the corresponding recording files were played according to the grouping until the tracheal intubation was removed.The survey tools were pediatric anesthesia emergence delirium?PAED?scale,Face,Leg,Activity,Crying,Consolability?FLACC?pain assessment scale,parental separation anxiety scale?PSAS?and objective monitoring data:heart rate?HR?,systolic blood pressure?SBP?,diastolic blood pressure?DBP?,pulse blood oxygen saturation?SpO₂?and stage time of recovery period?duration of recovery from spontaneous breathing,duration of eye opening,duration of tracheal tube removal and duration of resuscitation?.SPSS21.0 was used to analyze the data.Results:The main outcome:1.Severity of emergence agitation:The PAED scores of maternal recording group?7.06±2.58?,stranger's recording group?9.18±2.49?and control group?10.85±2.65?were significantly different?p<0.001?.By pairwise comparison,there were statistically significant differences between maternal recording group and stranger's recording group?p=0.001?,maternal recording group and control group?p<0.001?,stranger's recording group and control group?p<0.01?.2.Incidence of emergence agitation:The incidence of emergence agitation was 17.6%in maternal recording group,38.2%in stranger's recording group,and 58.8%in control group,with statistically significant differences?p<0.05?.By pairwise comparison,there was statistically significant difference between maternal recording group and control group?p<0.017?.There were no statistically significant differences between maternal recording group and stranger's recording group,stranger's recording group and control group?p>0.017?.The secondary outcome:1.FLACC score:The difference of FLACC score among maternal recording group?1.53±1.05?,stranger's recording group?1.68±0.77?,and control group?1.71±0.87?,was no statistically significant?p>0.05?.2.Vital signs:?1?Comparison of Heart Rate?HR?:when endotracheal tube was removed,the difference of HR among three groups was statistically significant?F=9.449,p<0.001?.By pairwise comparison,the HR of maternal recording group was significantly lower than stranger's recording group?p=0.045?and control group?p<0.001?,with statistically significant differences.?2?Comparison of Systolic Blood Pressure?SBP?:when endotracheal tube was removed,the difference of SBP among three groups was statistically significant?F=12.056,p<0.001?.By pairwise comparison,the SBP of maternal recording group was significantly lower than stranger‘s recording group?p=0.003?and control group?p<0.001?,with statistically significant differences.5mins after removed the endotracheal tube,the difference of SBP among three groups was statistically significant?F=3.874,p=0.024?.By pairwise comparison,there was statistically significant difference of SBP between maternal recording group and control group?p=0.029?.?3?Comparison of diastolic blood pressure?DBP?:the difference of DBP among three groups was statistically significant?F=6.443,p=0.002?.By pairwise comparison,the DBP of maternal recording group was significantly lower than stranger's recording group?p=0.009?and control group?p=0.006?,with statistically significant differences.5mins after removed the tracheal tube,the differences of DBP among three groups were statistically significant?F=3.871,p=0.024?.By pairwise comparison,there was statistically significant difference of DBP between maternal recording group and control group?p=0.019?.?4?Comparison of pulse oxygen saturation?SpO₂?:there was no statistically significant difference of SpO₂ among maternal recording group,stranger's recording group and control group?F=0.787,p=0.562?.3.Stage time of recovery period:?1?Duration of eye opening:the difference of duration of eye opening among three groups was statistically significant?F=7.472,p=0.001?.By pairwise comparison,there was statistically significant differences of duration of eye opening between maternal recording group and control group?p<0.001?.There was statistically significant differences of duration of eye opening between stranger's recording group and control group?p=0.006?.?2?Duration of tracheal tube removal:the difference of duration of tracheal tube removal among three groups was statistically significant?F=6.570,p=0.002?.By pairwise comparison,there was statistically significant differences of duration of tracheal tube removal between maternal recording group and control group?p=0.001?.There was statistically significant differences of duration of tracheal tube removal between stranger's recording group and control group?p=0.006?.Conclusion:1.Recorded maternal voice can relieve the severity of emergence agitation during recovery period of children under general anesthesia and reduce the incidence.2.Recorded maternal voice can maintain the stability of heart rate,systolic blood pressure and diastolic blood pressure when endotracheal tube removal of children under general anesthesia.3.Recorded maternal voice can shorten the duration of eye opening and the duration of endotracheal tube removal during recovery period of children under general anesthesia.4.The effect of recorded maternal voice on recovery for general anesthesia in children is safe,effective,simple and feasible,which is worthy of clinical promotion.