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丙泊酚对七氟醚全身麻醉后儿童苏醒行为的影响。

Effect of propofol on emergence behavior in children after sevoflurane general anesthesia.

作者信息

Abu-Shahwan Ibrahim

机构信息

Department of Anesthesiology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.

出版信息

Paediatr Anaesth. 2008 Jan;18(1):55-9. doi: 10.1111/j.1460-9592.2007.02376.x.

Abstract

BACKGROUND

Emergence agitation (EA) is a postoperative behavior that may occur in children undergoing general anesthesia with inhaled agents.

OBJECTIVES

The aim of the present study was to assess the effect of propofol administered at the end of sevoflurane anesthesia on the incidence and severity of EA in children undergoing magnetic resonance imaging (MRI).

METHODS

Eighty-four children, 2-7 years old, undergoing MRI were enrolled in this randomized double-blind study. No sedative premedication was administered prior to anesthesia induction. Anesthesia was induced and maintained with sevoflurane in N(2)O/O(2). Group P received propofol 1 mg.kg(-1) and group S received saline. Pediatric Anesthesia Emergence Delirium scale (PAEDs) was used to evaluate recovery characteristics upon awakening and during the first 30 min after emergence from anesthesia. Children with PAEDs >16 were considered agitated. EA was analyzed using the Mann-Whitney U-test. Demographic data and other side effects were analyzed using the Student's t-test.

RESULTS

Eighty-three children completed the study. There were 42 children in group P. EA was diagnosed in two children in the propofol group (4.8%) and in 11 children in the placebo group (26.8%, P < 0.05). Time to achieving postanesthesia care unit discharge criteria was not different between the two groups.

CONCLUSIONS

The addition of propofol 1 mg.kg(-1) can significantly decrease the incidence of EA after sevoflurane general anesthesia in children undergoing nonpainful procedures.

摘要

背景

苏醒期躁动(EA)是一种术后行为,可能发生在接受吸入性麻醉剂全身麻醉的儿童身上。

目的

本研究旨在评估七氟醚麻醉结束时给予丙泊酚对接受磁共振成像(MRI)检查的儿童EA发生率和严重程度的影响。

方法

84名2至7岁接受MRI检查的儿童被纳入这项随机双盲研究。麻醉诱导前未给予镇静性术前用药。麻醉诱导和维持采用七氟醚在N₂O/O₂中进行。P组给予丙泊酚1mg·kg⁻¹,S组给予生理盐水。采用小儿麻醉苏醒期谵妄量表(PAEDs)评估苏醒时及麻醉苏醒后最初30分钟内的恢复特征。PAEDs评分>16的儿童被视为躁动。采用Mann-Whitney U检验分析EA。使用Student's t检验分析人口统计学数据和其他副作用。

结果

83名儿童完成了研究。P组有42名儿童。丙泊酚组有2名儿童被诊断为EA(4.8%),安慰剂组有11名儿童(26.8%,P<0.05)。两组达到麻醉后护理单元出院标准的时间没有差异。

结论

在接受非疼痛性手术的儿童七氟醚全身麻醉后,添加1mg·kg⁻¹丙泊酚可显著降低EA的发生率。

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