Abstract：
OBJECTIVE: Emergence delirium (ED) presents challenges for both parents and health care providers in pediatric surgical settings. This study aims to evaluate the effectiveness of immersive virtual reality (VR) distraction and video distraction combined with parental presence in reducing ED in preschool-aged children undergoing elective surgery.
METHODS: A prospective, randomized, controlled clinical trial was conducted with 90 children ages 4 to 7. Participants were randomly assigned to three groups: VR distraction (group V), tablet video distraction with parental presence (group T), and standard care (group C). The primary endpoints were the incidence of ED and Pediatric Anesthesia Emergence Delirium Scale scores, with secondary measures encompassing scores from the Parental Separation Anxiety Scale and the Faces, Legs, Activity, Cry, Consolability (FLACC) scale.
METHODS: Participants were assigned to one of the three intervention groups, and relevant scales were used to assess ED, parental separation anxiety, and postoperative pain. The immersive VR distraction and video distraction with parental presence interventions were compared against standard care.
RESULTS: Immersive VR distraction significantly reduced the incidence of ED (6.67% in group V vs 40% in group T and 60% in group C), and the incidence of ED in group V was notably lower than in the other groups (P = .023 vs group T and P = .004 vs group C). Children in group V displayed significantly lower FLACC compared with the other groups as well (P < .05). However, no significant differences between the 3 groups were observed in perioperative anxiety as assessed by the Parental Separation Anxiety Scale scores (P = .27).
CONCLUSIONS: This study underscores the potential of immersive VR distraction as an effective intervention for mitigating ED in pediatric surgical patients. The findings suggest that incorporating VR technology during the perioperative period can positively impact postoperative outcomes. Further research in diverse surgical contexts is recommended to validate these findings and explore the broader applicability of VR distraction in pediatric health care settings.
METHODS: A prospective, randomized, controlled clinical trial was conducted with 90 children ages 4 to 7. Participants were randomly assigned to three groups: VR distraction (group V), tablet video distraction with parental presence (group T), and standard care (group C). The primary endpoints were the incidence of ED and Pediatric Anesthesia Emergence Delirium Scale scores, with secondary measures encompassing scores from the Parental Separation Anxiety Scale and the Faces, Legs, Activity, Cry, Consolability (FLACC) scale.
METHODS: Participants were assigned to one of the three intervention groups, and relevant scales were used to assess ED, parental separation anxiety, and postoperative pain. The immersive VR distraction and video distraction with parental presence interventions were compared against standard care.
RESULTS: Immersive VR distraction significantly reduced the incidence of ED (6.67% in group V vs 40% in group T and 60% in group C), and the incidence of ED in group V was notably lower than in the other groups (P = .023 vs group T and P = .004 vs group C). Children in group V displayed significantly lower FLACC compared with the other groups as well (P < .05). However, no significant differences between the 3 groups were observed in perioperative anxiety as assessed by the Parental Separation Anxiety Scale scores (P = .27).
CONCLUSIONS: This study underscores the potential of immersive VR distraction as an effective intervention for mitigating ED in pediatric surgical patients. The findings suggest that incorporating VR technology during the perioperative period can positively impact postoperative outcomes. Further research in diverse surgical contexts is recommended to validate these findings and explore the broader applicability of VR distraction in pediatric health care settings.
摘要：
目的：出现谵妄（ED）对儿科手术中的父母和医护人员都提出了挑战。这项研究旨在评估沉浸式虚拟现实（VR）分心和视频分心结合父母在场在减少接受择期手术的学龄前儿童ED方面的有效性。
方法：前瞻性，随机化，对90名4至7岁儿童进行了对照临床试验。参与者被随机分配到三组：VR分心（V组），父母在场的平板电脑视频分心(T组)，和标准护理（C组）。主要终点是ED发生率和小儿麻醉出现谵妄量表评分，次要指标包括父母分离焦虑量表和面孔的分数，腿,活动,哭吧,可协性(FLACC)量表。
方法：参与者被分配到三个干预组之一，并使用相关量表评估ED，父母分离焦虑，和术后疼痛。将父母在场干预的沉浸式VR分心和视频分心与标准护理进行了比较。
结果：沉浸式VR分心显着降低了ED的发生率（V组为6.67％，T组为40％，C组为60％），V组ED的发生率明显低于其他组（P=0.023vsT组，P=0.004vsC组）。与其他组相比，V组儿童的FLACC明显降低（P<0.05）。然而,父母分离焦虑量表评分对3组患者围手术期焦虑无显著差异(P=.27).
结论：这项研究强调了沉浸式VR分散作为减轻儿科手术患者ED的有效干预措施的潜力。研究结果表明，在围手术期结合VR技术可以对术后结局产生积极影响。建议在不同的手术环境中进行进一步的研究，以验证这些发现，并探索VR分心在儿科医疗机构中的更广泛适用性。
方法：前瞻性，随机化，对90名4至7岁儿童进行了对照临床试验。参与者被随机分配到三组：VR分心（V组），父母在场的平板电脑视频分心(T组)，和标准护理（C组）。主要终点是ED发生率和小儿麻醉出现谵妄量表评分，次要指标包括父母分离焦虑量表和面孔的分数，腿,活动,哭吧,可协性(FLACC)量表。
方法：参与者被分配到三个干预组之一，并使用相关量表评估ED，父母分离焦虑，和术后疼痛。将父母在场干预的沉浸式VR分心和视频分心与标准护理进行了比较。
结果：沉浸式VR分心显着降低了ED的发生率（V组为6.67％，T组为40％，C组为60％），V组ED的发生率明显低于其他组（P=0.023vsT组，P=0.004vsC组）。与其他组相比，V组儿童的FLACC明显降低（P<0.05）。然而,父母分离焦虑量表评分对3组患者围手术期焦虑无显著差异(P=.27).
结论：这项研究强调了沉浸式VR分散作为减轻儿科手术患者ED的有效干预措施的潜力。研究结果表明，在围手术期结合VR技术可以对术后结局产生积极影响。建议在不同的手术环境中进行进一步的研究，以验证这些发现，并探索VR分心在儿科医疗机构中的更广泛适用性。
