11 intervention measures for children's agitation during anesthesia recovery

In pediatric anesthesia, restlessness during the recovery period is a thorny issue. Using medication to control it is obviously not the best option, as it may cause unnecessary effects on the child's body. However, if medication is not used, there seems to be no better solution. Below, we review 11 intervention measures for pediatric restlessness during the recovery period.

(1) Parents’ recordings: As the voice most familiar to the child, the mother’s voice is often used. It is collected by the nurse before the operation and mainly contains encouraging words and calling the child’s name. It is used when the child wakes up.

(2) Parental companionship (during induction and awakening): Parents and children enter the operating room together, accompany the children before induction and after awakening, and comfort the children.

(3) Video call with mother: Make a video call with mother after waking up.

(4) Perioperative psychological intervention: nurses mainly provide psychological intervention to parents and children before, during and after surgery. Compared with conventional education, it focuses more on reducing the psychological stress of children and improving their psychological tolerance threshold.

(5) Distraction (toys, gift boxes, videos, etc.): Use various objects to distract the child before induction.

(6) Phototherapy: Expose the child to a preset blue light.

(7) Audiovisual rehearsal: During the preoperative visit, a video is played for the child and his parents. The video shows two doctors interacting in a humorous way, simulating the child's perspective, and rehearsing what the child will see and feel when entering the operating room for anesthesia, including the operating room environment and temperature, the mask, ECG monitor, pulse oximeter, electrodes that the child will use, and the reasonable fear that the child may feel.

(8) Blindfold test: Use an eye mask before surgery to simulate the patient's condition after eye surgery.

(9) Drink lightly before surgery: The child should drink an appropriate amount of water or 5% glucose solution before surgery.

(10) White noise therapy: Play white noise audio during the waking period for intervention.

(11) Combined interventions: This type of research combines two or more interventions to form a comprehensive strategy or care model, which usually runs throughout the entire perioperative period, such as parent-dedicated nurse companionship, perioperative joint cognitive intervention, perioperative comfort care, touch care combined with mother's voice, problem-oriented care model, preoperative structured education and postoperative visits.

The content of this article is derived from domestic and foreign database searches. The literature search scope includes PubMed, Embase, CINAHL, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang and China Biomedical Database. The English search terms are "agitation/e-mergence agitation/resuscitation agitation/EA/"'children/preschool children/pediatric/kid"; the Chinese search terms are "agitation/awakening agitation/recovery agitation" and "children/preschool children/pediatrics/children". The search time limit is from the establishment of the database to January 31, 2023.

It can be said that the eleven methods mentioned above have a data basis. However, the situation of each hospital is different, and it may not be easy to implement.

So, which method do you think is easier to implement? Welcome to leave a message to discuss~

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