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全身麻醉下小儿患者的麻醉后苏醒期躁动

Postanesthetic Emergence Agitation in Pediatric Patients under General Anesthesia.

作者信息

Mohkamkar Masoumeh, Farhoudi Fatemeh, Alam-Sahebpour Alireza, Mousavi Seyed-Abdullah, Khani Soghra, Shahmohammadi Soheila

机构信息

Postanesthetic Care Unit, Bouali Sina Hospital.

Department of Anesthesiology.

出版信息

Iran J Pediatr. 2014 Apr;24(2):184-90.

Abstract

OBJECTIVE

Postanesthetic emergence agitation is a common problem in pediatric postanesthetic care unit with an incidence ranging from 10 to 80%. This study was done to determine the prevalence of emergence agitation and associated risk factors in pediatric patients who underwent general anesthesia.

METHODS

This cross-sectional descriptive and analytic study was performed on 747 pediatric patients aged 3- 7 years that underwent general anesthesia for various elective surgeries at Bou-Ali Sina Hospital in Sari, Iran between January 2010 and January 2011. A non-probability quota sampling technique was used. The presence of emergence agitation was recorded using Pediatric Anesthesia Emergence Delirium Scale. The factors linked with Emergence Agitation were recorded in a questionnaire. The data were analyzed using SPSS software 16 and independent sample t-test, χ(2) and binary logistic regression. P-values less than 0.05 were considered as significant.

FINDINGS

One hundred thirty-four (17.9%) children had emergence agitation. The most frequent surgical procedures were ENT surgical procedures 315 (42.2%), abdominal surgery 177 (23.7%), orthopedic surgery 137 (18.3%), urology 97 (13%) and ophthalmic surgery 24 (3.2%). Otorhinolaryngological surgical procedures (P=0.001), pain (P<0.05) and induction behavior of children (P<0.005) were associated with higher rates of post anesthetic emergence agitation (P=0.001).

CONCLUSION

This study identified the multiple independent risk factors which are associated with emergence agitation in children. To minimize the incidence of postanesthetic emergence agitation, these risk factors should be considered in the routine care by care providers in postanesthetic care unit.

摘要

目的

麻醉苏醒期躁动是小儿麻醉后护理单元常见的问题,发生率在10%至80%之间。本研究旨在确定接受全身麻醉的小儿患者中苏醒期躁动的患病率及相关危险因素。

方法

本横断面描述性和分析性研究于2010年1月至2011年1月在伊朗萨里的布阿里·西纳医院对747例3至7岁接受各种择期手术全身麻醉的小儿患者进行。采用非概率配额抽样技术。使用小儿麻醉苏醒期谵妄量表记录苏醒期躁动的存在情况。与苏醒期躁动相关的因素记录在问卷中。数据使用SPSS软件16进行分析,并采用独立样本t检验、χ²检验和二元逻辑回归分析。P值小于0.05被认为具有统计学意义。

结果

134例(17.9%)儿童出现苏醒期躁动。最常见的外科手术是耳鼻喉科手术315例(42.2%)、腹部手术177例(23.7%)、骨科手术137例(18.3%)、泌尿外科手术97例(13%)和眼科手术24例(3.2%)。耳鼻喉科手术(P = 0.001)、疼痛(P < 0.05)和儿童的诱导行为(P < 0.005)与麻醉后苏醒期躁动的发生率较高相关(P = 0.001)。

结论

本研究确定了与儿童苏醒期躁动相关的多个独立危险因素。为尽量减少麻醉后苏醒期躁动的发生率,麻醉后护理单元的护理人员在常规护理中应考虑这些危险因素。

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