【罂粟摘要】催眠替代全身麻醉用于儿科表面手术：一项随机对照试验

催眠替代全身麻醉用于儿科表面手术：一项随机对照试验

贵州医科大学麻醉与心脏电生理课题组

翻译：佟睿

编辑：宋雨婷

审校：曹莹

背景

减少儿童围手术期焦虑和缓减疼痛，对于儿童和他们的父母来说都是优化康复和预后的关键。催眠通过作用于焦虑和疼痛的感觉和情感调节，被广泛应用于医疗保健，特别是在麻醉中。这项随机对照临床试验旨在比较全身麻醉和术中催眠对接受表面手术的儿童围术期影响。

方法

研究对象为7岁至16岁的拟行日间表面手术的患儿，随机分为全麻组和催眠组。主要观察指标是住院时间。此外，还评估了儿童和父母的焦虑情况、儿童疼痛和术后负面行为改变的发生情况。

结果

60名平均年龄为10.3岁(标准差：2.6)的儿童参加了这项研究。除一例外，所有病例的催眠都很成功。催眠组住院时间的中位数(25-75%)较短(120min[95-145]比240.5 min[218-275]分钟；P<0.001)。全麻组儿童(30%比11%，P=0.001)和家长(55%比30%；P＝0.05)的术前焦虑发生率较高。疼痛评分在不同组之间没有差异。没有负面术后行为改变的报道。

结论

在7岁16岁的儿童中，催眠似乎是可行且易于接受的。围手术期的质量和快速恢复支持催眠作为儿科表面手术全身麻醉的一种有效和安全的替代方案。

原始文献来源：

Chrystelle Sola, Julie Devigne, Sophie Bringuier, et al. Hypnosis as an alternative to general anaesthesia for paediatric superficial surgery: a randomised controlled trial. [J]Br J Anae 130 (3): 314-321 (2023), doi: 10.1016/j.bja.2022.11.023.

英文原文

Hypnosis as an alternative to general anaesthesia for paediatric superficial surgery: a randomised controlled trial

Background: Reducing perioperative anxiety and controlling pain in children are essential to optimise recovery and outcomes for both children and their parents. By acting on sensory and affective modulation of anxiety and pain, hypnosis is widely used in medical care, especially in anaesthesia. This randomised controlled clinical trial was designed to compare general anaesthesia and intraoperative hypnosis support for perioperative management of children undergoing superficial surgery.

Method: Children aged 7-16 yr scheduled for day-case superficial surgery were included and randomly assigned to one of the following two groups: general anaesthesia group or hypnosis group. The primary outcome was length of hospital stay. Child and parent anxiety, child pain, and the occurrence of postoperative negative behavioural changes were also evaluated.

Results: Sixty children of mean age 10.3 (standard deviation: 2.6) yr were enrolled in the study. Hypnosis was successful in all but one case. The median (25th-75th percentile) length of hospital stay was shorter in the hypnosis group (120 [95-145] vs 240.5 [218-275] min; P<0.001). The general anaesthesia group was associated with a greater incidence of high levels of preoperative anxiety in children (30 vs 11%; P=0.001) and parents (55 vs 30%; P=0.05). Pain scores did not differ between groups. No negative postoperative behavioural changes were reported.

Conclusion: In children aged 7-16 yr, hypnosis appears to be feasible and accepted. The quality of the perioperative experience and the rapid recovery support the use of hypnosis as an effective and safe alternative to general anaesthesia for paediatric superficial surgery.

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