Kanaya Akihiro, Kuratani Norifumi, Nakata Yoshinori, Yamauchi Masanori
1Department of Anesthesiology and Perioperative Medicine, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan.
2Department of Anesthesia, Saitama Children's Medical Center, Saitama, Japan.
JA Clin Rep. 2017;3(1):38. doi: 10.1186/s40981-017-0108-3. Epub 2017 Jul 26.
In pediatric general anesthesia, our goal should be quicker extubation to facilitate rapid turnover in the operating room without compromising on safety and quality of anesthesia. Although many studies have focused on improving safety and pursuing a higher quality of recovery, factors related to anesthesia emergence remain unclear. We must, therefore, identify factors that influence the process of emergence from general anesthesia in children.
We retrospectively examined 148 children (aged 1-6 years, American Society of Anesthesiologists physical status: 1-2) who had undergone <2 h of ambulatory surgery. Clinical measures included time from the end of surgery to extubation (extubation time), age, height, weight, surgical time, mean indirect blood pressure during surgery, mean heart rate during surgery, mean end-tidal carbon dioxide during surgery (mETCO), mean body temperature during surgery (mBT), and total amount of fentanyl. Anesthetic procedures involved sevoflurane or propofol. Multiple regression analysis revealed that mETCO ( < 0.01) and mBT ( < 0.01) were independent clinical factors associated with extubation time following pediatric ambulatory surgery.
This study of 148 pediatric patients demonstrated that anesthesia emergence may be associated with mBT and mETCO following pediatric ambulatory surgery. These results show that perioperative vital signs are important in the prevention of delayed emergence for pediatric patients.
在小儿全身麻醉中,我们的目标应该是更快地拔管,以促进手术室的快速周转,同时不影响麻醉的安全性和质量。尽管许多研究都集中在提高安全性和追求更高质量的恢复,但与麻醉苏醒相关的因素仍不明确。因此,我们必须确定影响小儿全身麻醉苏醒过程的因素。
我们回顾性研究了148例接受门诊手术且手术时间小于2小时的儿童(年龄1 - 6岁,美国麻醉医师协会身体状况分级:1 - 2级)。临床测量指标包括从手术结束到拔管的时间(拔管时间)、年龄、身高、体重、手术时间、手术期间平均间接血压、手术期间平均心率、手术期间平均呼气末二氧化碳分压(mETCO)、手术期间平均体温(mBT)以及芬太尼总量。麻醉方法包括七氟烷或丙泊酚。多元回归分析显示,mETCO(<0.01)和mBT(<0.01)是小儿门诊手术后与拔管时间相关的独立临床因素。
这项对148例儿科患者的研究表明,小儿门诊手术后的麻醉苏醒可能与mBT和mETCO有关。这些结果表明,围手术期生命体征对于预防小儿患者苏醒延迟很重要。