A cohort study of the incidence and risk factors for negative behavior changes in children after general anesthesia
A cohort study of the incidence and risk factors for negative behavior changes in children after general anesthesia
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DOI：
10.1111/j.1460-9592.2006.01869.x
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发表时间：
2006-08-01
影响因子：
1.7
通讯作者：
Jamsen, Kris
中科院分区：
文献类型：
--
作者：
Stargatt, Robyn;Davidson, Andrew J.;Jamsen, Kris
背景资料：住院和麻醉会对儿童产生实质性的心理影响，这可能表现为负面的行为变化。本研究的主要目的是估计负性行为变化postanesthesia在一个大的队列的儿童的发病率，并确定可能的危险因素：一千二百五十名儿童年龄从3至12岁的各种程序麻醉入组。绝对版的弗农住院后行为问卷（PHBQ）用于评估麻醉后3天和30天的行为变化。七项或七项以上行为的恶化被定义为显著的负面行为变化。记录人口统计学数据、麻醉细节、准备类型和程度、手术细节和住院时间。结果：24%的儿童在第3天和16%的儿童在第30天有显著的负性行为改变。经Logistic回归分析，与第3天显著负性行为变化相关的因素是父母状态焦虑增加、年龄较小、住院过夜、出生顺序较低以及通过与麻醉师讨论进行准备。在第30天，较长的住院时间，较年轻的年龄，阅读麻醉准备书和以前的困难麻醉经验与显着的负面行为变化。同样在第30天，阅读麻醉准备书与接受短期手术的儿童的不良行为变化密切相关，但与接受长期手术的儿童无关。然而，在3和30天，包括在models.Conclusions的因素解释的变异量是低的：显着的负面行为的变化可能会发生在儿童麻醉后。很难准确预测哪些孩子会发生这种情况，然而，一些个人，家庭和程序变量与显着的负面行为变化有关。如果使用，应根据手术复杂程度考虑准备。
Background: Hospitalization and anesthesia can have a substantial psychological impact on children, which may be manifested by negative behavioral change. The primary aims of this study were to estimate the incidence of negative behavior change postanesthesia in a large cohort of children, and to identify the possible risk factors.Methods: One thousand two hundred and fifty children aged from 3 to 12 years scheduled for anesthesia for a variety of procedures were enrolled. The absolute version of the Vernon Post Hospitalization Behavior Questionnaire (PHBQ) was used to assess behavior change at 3 and 30 days postanesthesia. Deterioration in seven or more items of behavior was defined to be a significant negative behavior change. Demographic data, anesthesia details, type and extent of preparation, details of procedure and length of hospitalization were recorded. Child temperament, child anxiety and parental anxiety were also measured.Results: Twenty-four percent of children had significant negative behavior change at day 3 and 16% at day 30. After logistic regression, factors associated with significant negative behavior change at 3 days were increased parental state anxiety, younger age, overnight admission, lower birth order and preparation via having a discussion with the anesthetist. At day 30, longer hospitalization, younger age, reading the anesthesia preparation book and a previous difficult anesthesia experience were associated with significant negative behavior change. Also at day 30, reading the anesthesia preparation book was strongly associated with negative behavior change in children having short procedures, but not longer procedures. However, at both 3 and 30 days, the amount of variability explained by factors included in the models was low.Conclusions: Significant negative behavior change can occur in children after anesthesia. It is difficult to precisely predict in which children this will occur, however, some individual, family and procedural variables are associated with significant negative behavior change. If used, preparation should be considered according to level of surgical complexity.