Zhong Qiaosheng, Qu Xianfeng, Xu Chuanhua
Department of Anesthesiology, Xiamen Changgung Hospital, Xiamen, Fujian 361028, PR China.
Department of Anesthesiology, Taizhou Municipal Hospital, Taizhou, Zhejiang 318000, PR China.
Int J Pediatr Otorhinolaryngol. 2018 Jan;104:32-35. doi: 10.1016/j.ijporl.2017.10.038. Epub 2017 Oct 31.
Emergence agitation (EA) is a common complication in children during recovery from sevoflurane anesthesia with an high incidence. The main objective of this study was to compare the effects of preoperative visiting operation room (PVOR) to administration of propofol at the end of anesthesia on EA in preschool children under sevoflurane anesthesia.
Sixty-nine preschool children aged from 3 to 6 years scheduled for tonsillectomy under sevoflurane anesthesia were randomly allocated to one of the three groups to receive either PVOR (Group PV), routine preoperative visit (Group RV) or routine preoperative visit plus propofol (Group RP), 23 patients were included in each group. General anesthesia was induced and maintained with sevoflurane. Parental separation status score, mask acceptance score, Aono's four point score and pediatric anesthesia emergence delirium (PAED) score and incidence of EA were recorded. PAED score >10 were regarded as EA. Recovery profile and adverse events were also recorded.
Parental separation status score and mask acceptance score in group PV was significantly lower than that in group RV and group RP (P < 0.05); Aono's four point score, PAED score and incidence of EA in group PV and group RP was significantly lower than that in group RV (P < 0.05); Time to extubation and time to interaction in group PV and group RV was significantly shorter than that in group RP (P < 0.05); POV and rescue by fentanyl in group PV and group RP was significantly lower than that in group RV(P < 0.05).
PVOR can effectively reduce the incidence of EA as well as administration of propofol without additional medical expenses and other adverse effects.
苏醒期躁动(EA)是七氟醚麻醉苏醒期儿童常见的并发症,发生率较高。本研究的主要目的是比较术前参观手术室(PVOR)与麻醉结束时使用丙泊酚对七氟醚麻醉下学龄前儿童EA的影响。
69例计划在七氟醚麻醉下行扁桃体切除术的3至6岁学龄前儿童被随机分为三组,分别接受术前参观手术室(PV组)、常规术前访视(RV组)或常规术前访视加丙泊酚(RP组),每组23例。采用七氟醚诱导和维持全身麻醉。记录家长分离状态评分、面罩接受度评分、青野四点评分、小儿麻醉苏醒期谵妄(PAED)评分及EA发生率。PAED评分>10分被视为EA。还记录了恢复情况和不良事件。
PV组的家长分离状态评分和面罩接受度评分显著低于RV组和RP组(P<0.05);PV组和RP组的青野四点评分、PAED评分及EA发生率显著低于RV组(P<0.05);PV组和RV组的拔管时间和恢复交流时间显著短于RP组(P<0.05);PV组和RP组的术后疼痛视觉模拟评分(POV)及芬太尼补救使用率显著低于RV组(P<0.05)。
术前参观手术室可有效降低EA的发生率,且与使用丙泊酚效果相当,无额外医疗费用及其他不良反应。