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Ebeveyn Farkındalığının Genel Anestezi Altında Günübirlik Pediyatrik Diş Tedavisi Öncesi Açlık Uyumuna Etkisi: Prospektif Gözlemsel Çalışma

Yıl 2024, Cilt: 11 Sayı: 2, 187 - 191, 19.08.2024
https://doi.org/10.15311/selcukdentj.1495983

Öz

ÖZ
Amaç
Çocuk hastalarda pulmoner aspirasyon riskini en aza indirmek için ameliyat öncesi açlıkla ilgili kılavuzların önerileri uygulanır. Bu çalışma genel anestezi (GA) altında günübirlik diş tedavisi yapılan çocuklarda ebeveyn farkındalığının ameliyat öncesi açlık uyumuna etkisini değerlendirmek ve bunu etkileyen faktörlerin belirlenmek amacıyla planlandı.
Gereç ve Yöntemler
Bu çalışmaya ASAI-II, 88 çocuk hastanın ebeveynleri dahil edildi. Çalışmanın birinci kısmında, ebeveynler çocuklarının ameliyat öncesi açlığı ile ilgili talimatları anestezi öncesi konsültasyon sırasında hem sözlü hem de yazılı talimatlar yoluyla aldılar. İkinci kısmında hastalar GAi ameliyathanesine geldiğinde, cerrahi prosedürden sorumlu anestezi uzmanı tarafından ebeveynlere doldurmaları için anket formu verildi.
Bulgular
Hastalarda GA öncesi açlık süreleri katı gıdalar için ortalama 10 saat, berrak sıvılar için 8 saat bulundu. Ebeveyn eğitim durumu lise olan hastaların katı gıda açlık süreleri ortalama 11 saat ile diğer gruplardan daha uzun bulundu (p=0,017). ‘Hastanızın aç bırakılma sebebi ne olabilir?’ sorusuna “Kusma riski” ve “Gıdaların solunum yoluna kaçma riski” cevabı veren ebeveynlerin hastalarında sıvı açlık süreleri diğer cevapları verenlere göre daha kısa bulundu (p=0,002). ‘Hastanız Neden Önerilenden Uzun Süre Aç Kaldı?’ sorusuna 64 (%72,7) ebeveyn ‘Uykusunu Bölmek İstemedim’, 24 (%27,3) ebeveyn ‘Sebebi Yok’ yanıtını verdi.
Sonuç
Ameliyat öncesi dönemde çocukların açlık sürelerine ilişkin ebeveynlerin daha iyi uyum sağlaması ve endişelerinin giderilmesi için anlaşılır talimatlar, hatırlatma aramaları, eğitici videolar ve iletişim kaynaklarının sağlanması gereklidir.
Anahtar Kelimeler
Açlık; ebeveyn farkındalığı; çocuk hasta; ameliyat öncesi dönem

Kaynakça

  • 1. Davies, A., Pang, W.S., Fowler, T., Dewi, F., and Wright, T. (2018). Preoperative fasting in the department of plastic surgery. BMJ Open Quality 7, e000161. 10.1136/bmjoq-2017-000161.
  • 2. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration*. (2017). Anesthesiology 126, 376-393. 10.1097/aln.0000000000001452.
  • 3. Thomas, M., Morrison, C., Newton, R., and Schindler, E. (2018). Consensus statement on clear fluids fasting for elective pediatric general anesthesia. Pediatric Anesthesia 28, 411-414.
  • 4. Joshi, G.P., Abdelmalak, B.B., Weigel, W.A., Harbell, M.W., Kuo, C.I., Soriano, S.G., Stricker, P.A., Tipton, T., Grant, M.D., Marbella, A.M., et al. (2023). 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration—A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting*. Anesthesiology 138, 132-151. 10.1097/aln.0000000000004381.
  • 5. Frykholm, P., Disma, N., Andersson, H., Beck, C., Bouvet, L., Cercueil, E., Elliott, E., Hofmann, J., Isserman, R., and Klaucane, A. (2022). Pre-operative fasting in children: A guideline from the European Society of Anaesthesiology and Intensive Care. European Journal of Anaesthesiology| EJA 39, 4-25.
  • 6. Al‐Robeye, A.M., Barnard, A.N., and Bew, S. (2020). Thirsty work: Exploring children's experiences of preoperative fasting. Pediatric Anesthesia 30, 43-49.
  • 7. Schmitz, A., Kellenberger, C.J., Neuhaus, D., Schroeter, E., Deanovic, D., Prüfer, F., Studhalter, M., Völlmer, L., and Weiss, M. (2011). Fasting times and gastric contents volume in children undergoing deep propofol sedation–an assessment using magnetic resonance imaging. Pediatric Anesthesia 21, 685-690.
  • 8. Engelhardt, T., Wilson, G., Horne, L., Weiss, M., and Schmitz, A. (2011). Are you hungry? Are you thirsty?–fasting times in elective outpatient pediatric patients. Pediatric Anesthesia 21, 964-968.
  • 9. Cantellow, S., Lightfoot, J., Bould, H., and Beringer, R. (2012). Parents’ understanding of and compliance with fasting instruction for pediatric day case surgery. Pediatric Anesthesia 22, 897-900.
  • 10. Aras, D., Cil, C., Akçaoğlu, A.C., Erbay, R.H., and Zencir, M. (2009). DENİZLİİLİ YENİŞEHİR SAĞLIK OCAĞI BÖLGESİNDE HALKIN ANESTEZİYOLOJİ UYGULAMALARINA İLİŞKİN BİLGİ, TUTUM VE ÖNCEKİANESTEZİ DENEYİMLERİ. Pamukkale Tıp Dergisi.
  • 11. Osinaike, B.B., Dairo, M., Oyebamiji, E., Odesanya, J., and Tanimowo, A. (2007). Attitude of general public to risks associated with anaesthesia. East Afr J Public Health 4, 40-42.
  • 12. Singla, K., Bala, I., Jain, D., Bharti, N., and Samujh, R. (2020). Parents' perception and factors affecting compliance with preoperative fasting instructions in children undergoing day care surgery: A prospective observational study. Indian journal of anaesthesia 64, 210-215.
  • 13. Klemetti, S., Kinnunen, I., Suominen, T., Antila, H., Vahlberg, T., Grenman, R., and Leino-Kilpi, H. (2010). The effect of preoperative nutritional face-to-face counseling about child's fasting on parental knowledge, preoperative need-for-information, and anxiety, in pediatric ambulatory tonsillectomy. Patient education and counseling 80, 64-70.

Effect of Parental Awareness on Fasting Compliance Before Ambulatory Pediatric Dental Treatment Under General Anesthesia: Prospective Observational Study

Yıl 2024, Cilt: 11 Sayı: 2, 187 - 191, 19.08.2024
https://doi.org/10.15311/selcukdentj.1495983

Öz

ABSTRACT
Background
The preoperative fasting guidelines are adhered to reduce the risk of pulmonary aspiration in pediatric patients. This study was planned to evaluate the effect of parental awareness on preoperative fasting compliance in children undergoing ambulatory dental treatment under general anesthesia (GA) and to determine the factors affecting this.
Materials and Methods
Parents of 88 ASAI-II pediatric patients were included in this study. In the first part of the study, parents received instructions regarding their child's preoperative fasting through both verbal and written instructions during the anesthesia consultation. In the second part, when the patients came to the GA operating room, the parents were given a questionnaire to fill out by the anesthesiologist responsible for the surgical procedure.
Results
The average fasting period in patients before GA was 10 hours for solid foods and 8 hours for clear liquids. The solid food fasting period of patients whose parents had high school education was found to be longer than the other groups, with an average of 11 hours (p = 0.017). To the question 'What could be the reason for starving your patient?', the patients whose parents answered, "Risk of vomiting" and "Risk of food escaping into the respiratory tract" had shorter periods of liquid fasting than those who gave other answers (p=0.002). To the question 'Why Did Your Patient Stay Fast for Longer Than Recommended?', 64 (72.7%) parents answered, 'I Didn't Want to Disrupt His Sleep,’, and 24 (27.3%) parents answered, 'No Reason.'
Conclusion
Clear instructions, reminder calls, educational videos, and communication resources are necessary to better adapt parents and alleviate their concerns regarding children's fasting periods during the preoperative period.
Keywords
Fasting; parents’ awareness; child; preoperative period

Kaynakça

  • 1. Davies, A., Pang, W.S., Fowler, T., Dewi, F., and Wright, T. (2018). Preoperative fasting in the department of plastic surgery. BMJ Open Quality 7, e000161. 10.1136/bmjoq-2017-000161.
  • 2. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration*. (2017). Anesthesiology 126, 376-393. 10.1097/aln.0000000000001452.
  • 3. Thomas, M., Morrison, C., Newton, R., and Schindler, E. (2018). Consensus statement on clear fluids fasting for elective pediatric general anesthesia. Pediatric Anesthesia 28, 411-414.
  • 4. Joshi, G.P., Abdelmalak, B.B., Weigel, W.A., Harbell, M.W., Kuo, C.I., Soriano, S.G., Stricker, P.A., Tipton, T., Grant, M.D., Marbella, A.M., et al. (2023). 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration—A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting*. Anesthesiology 138, 132-151. 10.1097/aln.0000000000004381.
  • 5. Frykholm, P., Disma, N., Andersson, H., Beck, C., Bouvet, L., Cercueil, E., Elliott, E., Hofmann, J., Isserman, R., and Klaucane, A. (2022). Pre-operative fasting in children: A guideline from the European Society of Anaesthesiology and Intensive Care. European Journal of Anaesthesiology| EJA 39, 4-25.
  • 6. Al‐Robeye, A.M., Barnard, A.N., and Bew, S. (2020). Thirsty work: Exploring children's experiences of preoperative fasting. Pediatric Anesthesia 30, 43-49.
  • 7. Schmitz, A., Kellenberger, C.J., Neuhaus, D., Schroeter, E., Deanovic, D., Prüfer, F., Studhalter, M., Völlmer, L., and Weiss, M. (2011). Fasting times and gastric contents volume in children undergoing deep propofol sedation–an assessment using magnetic resonance imaging. Pediatric Anesthesia 21, 685-690.
  • 8. Engelhardt, T., Wilson, G., Horne, L., Weiss, M., and Schmitz, A. (2011). Are you hungry? Are you thirsty?–fasting times in elective outpatient pediatric patients. Pediatric Anesthesia 21, 964-968.
  • 9. Cantellow, S., Lightfoot, J., Bould, H., and Beringer, R. (2012). Parents’ understanding of and compliance with fasting instruction for pediatric day case surgery. Pediatric Anesthesia 22, 897-900.
  • 10. Aras, D., Cil, C., Akçaoğlu, A.C., Erbay, R.H., and Zencir, M. (2009). DENİZLİİLİ YENİŞEHİR SAĞLIK OCAĞI BÖLGESİNDE HALKIN ANESTEZİYOLOJİ UYGULAMALARINA İLİŞKİN BİLGİ, TUTUM VE ÖNCEKİANESTEZİ DENEYİMLERİ. Pamukkale Tıp Dergisi.
  • 11. Osinaike, B.B., Dairo, M., Oyebamiji, E., Odesanya, J., and Tanimowo, A. (2007). Attitude of general public to risks associated with anaesthesia. East Afr J Public Health 4, 40-42.
  • 12. Singla, K., Bala, I., Jain, D., Bharti, N., and Samujh, R. (2020). Parents' perception and factors affecting compliance with preoperative fasting instructions in children undergoing day care surgery: A prospective observational study. Indian journal of anaesthesia 64, 210-215.
  • 13. Klemetti, S., Kinnunen, I., Suominen, T., Antila, H., Vahlberg, T., Grenman, R., and Leino-Kilpi, H. (2010). The effect of preoperative nutritional face-to-face counseling about child's fasting on parental knowledge, preoperative need-for-information, and anxiety, in pediatric ambulatory tonsillectomy. Patient education and counseling 80, 64-70.
Toplam 13 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Çocuk Diş Hekimliği
Bölüm Araştırma
Yazarlar

Funda Arun 0000-0001-7345-0318

Yayımlanma Tarihi 19 Ağustos 2024
Gönderilme Tarihi 4 Haziran 2024
Kabul Tarihi 24 Haziran 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 11 Sayı: 2

Kaynak Göster

Vancouver Arun F. Ebeveyn Farkındalığının Genel Anestezi Altında Günübirlik Pediyatrik Diş Tedavisi Öncesi Açlık Uyumuna Etkisi: Prospektif Gözlemsel Çalışma. Selcuk Dent J. 2024;11(2):187-91.