目的:发生谵妄是儿童常见的并发症。记录了母亲的声音,作为一种非药理措施,越来越多地用于预防儿科患者谵妄的出现,但仍需要足够的证据来证明其疗效。
方法:Embase,PubMed,科克伦图书馆,WebofScience,CINAHL,我们在Sinomed数据库中搜索了随机对照试验,这些试验探讨了记录的母亲声音在预防接受全身麻醉的儿科患者发生谵妄中的功效。原始数据与ReviewManager5.4.1进行荟萃分析。本研究是基于Cochrane综述方法进行的。
结果:分析中纳入了8项包含724名儿童的研究。与无语音(RR:0.45;[95%CI,0.34-0.61];p<0.01;I2=7%)或陌生人语音(RR:0.51;[95%CI,0.28-0.91];p=0.02;I2=38%)相比,记录的母亲语音降低了出现谵妄的发生率,而不增加其他不良反应。此外,与没有声音相比,它缩短了麻醉后护理单元的停留时间(MD=-5.64;[95%CI,-8.43至-2.58];p<0.01,I2=0%),但不是陌生人的声音(MD=-1.23;[95%CI,-3.08至0.63];p=0.19,I2=0%)。同时缩短了拔管时间,降低了术后抢救镇痛的发生率。
结论:目前的分析表明,记录母亲的声音可以降低急诊谵妄的发生率,缩短麻醉后监护病房停留时间和拔管时间,降低患儿术后抢救镇痛的发生率。
OBJECTIVE: Emergence delirium is a common complication in children. Recorded
mother\'s voice, as a non-pharmacological measure, is increasingly used to prevent the emergence of delirium in pediatric patients, but sufficient evidence is still needed to prove its efficacy.
METHODS: Embase, PubMed, Cochrane Library, Web of Science, CINAHL, and Sinomed databases were searched for randomized controlled trials exploring the efficacy of recorded
mother\'s voice in preventing the emergence of delirium in pediatric patients undergoing general anesthesia. The original data were pooled for the meta-analysis with Review Manager 5.4.1. This study was conducted based on the Cochrane Review Methods.
RESULTS: Eight studies with 724 children were included in the analysis. Recorded
mother\'s voice reduced the incidence of emergence delirium when compared with either no voice (RR: 0.45; [95 % CI, 0.34 - 0.61]; p < 0.01; I2 = 7 %) or stranger\'s voice (RR: 0.51; [95 % CI, 0.28 - 0.91]; p = 0.02; I2 = 38 %) without increasing other untoward reactions. In addition, it shortened the post-anesthesia care unit stay time when compared with no voice (MD = -5.64; [95 % CI, -8.43 to -2.58]; p < 0.01, I2 = 0 %), but not stranger\'s voice (MD = -1.23; [95 % CI, -3.08 to 0.63]; p = 0.19, I2 = 0 %). It also shortened the extubation time and reduced the incidence of postoperative rescue analgesia.
CONCLUSIONS: The current analysis indicated that recorded
mother\'s voices could reduce the incidence of emergency delirium, shorten post-anesthesia care unit stay time and extubation time, and decrease the incidence of postoperative rescue analgesia in children.