Pediatrik Cerrahi Hastalarında Anestezi Sonrası Deliryum Yönetiminde Hemşirelik Girişimleri

Öz

Anestezi sonrası deliryum (ASD), pediatrik cerrahi sonrası erken dönemde ortaya çıkan ajitasyon, huzursuzluk ve davranış değişiklikleriyle seyreden önemli bir postoperatif komplikasyondur. Çocuklarda sık görülen ASD, erken dönemde fark edilmediğinde ciddi sonuçlara yol açabilmektedir. Bu durum hastanın yataktan düşmesi, damar yolu veya cerrahi alanda hasar oluşması, iyileşme süresinin uzaması ve uzun vadede davranışsal sorunların gelişmesi gibi çeşitli komplikasyonlarla sonuçlanabilmektedir. Bu nedenle hemşireler, perioperatif dönemin tüm aşamalarında çocuğun davranışsal ve fizyolojik durumunu izleme, risk faktörlerini belirleme, uygun değerlendirme ölçeklerini kullanma ve zamanında müdahale etme açısından kritik bir role sahiptir. Güncel kanıtlar anne sesi, göz bandı uygulamaları, çevresel ışık düzenlemeleri ve perioperatif iletişim yöntemleri gibi nonfarmakolojik yaklaşımların ASD’yi azaltmada etkili olduğunu; farmakolojik yöntemler arasında ise özellikle deksmedetomidinin belirgin yarar sağladığını göstermektedir. Bu derleme, pediatrik cerrahi hastalarda ASD’nin tanılanması ve yönetiminde hemşirelik uygulamalarını güncel kanıtlar doğrultusunda ele alarak, güvenli ve bütüncül bakımın önemini vurgulamayı amaçlamaktadır.

Anahtar Kelimeler

• Anestezi sonrası deliryum
• çocuk sağlığı
• hemşirelik bakımı
• perioperatif dönem

Nursıng Interventıons In The Management Of Emergence Delırıum After Anaesthesıa In Paedıatrıc Surgery Patıents

Öz

Emergence delirium (ED) is an important postoperative complication that occurs in the early period after pediatric surgery and is characterized by agitation, restlessness, and behavioral changes. ED is common among children, and if not recognized early, it can lead to serious consequences. These may include complications such as falls from the bed, damage to intravenous lines or surgical sites, prolonged recovery time, and long-term behavioral problems. Therefore, nurses play a critical role throughout all phases of the perioperative period by monitoring the child’s behavioral and physiological status, identifying risk factors, using appropriate assessment tools, and providing timely interventions. Current evidence indicates that non-pharmacological approaches—such as maternal voice, eye mask application, environmental light adjustments, and perioperative communication techniques—are effective in reducing ED, while dexmedetomidine stands out as a particularly beneficial pharmacological option. This review aims to highlight the importance of safe and holistic care by addressing nursing practices in the identification and management of ED in pediatric surgical patients in line with up-to-date evidence.

Anahtar Kelimeler

• Emergence delirium
• child health
• nursing care
• perioperative period

Kaynakça

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