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区域麻醉与全身麻醉对儿童行为功能的影响。

The effect of regional anaesthesia versus general anaesthesia on behavioural functions in children.

机构信息

Paediatrics Department, Makassed General Hospital, Beirut, Lebanon.

Faculty of Public Health, Lebanese University, Beirut, Lebanon.

出版信息

Anaesth Crit Care Pain Med. 2019 Aug;38(4):357-361. doi: 10.1016/j.accpm.2018.03.012. Epub 2018 Apr 20.

Abstract

PURPOSE

The primary objective was to assess the effect of general anaesthesia versus regional anaesthesia in a single exposure before the age of 2 years on the development of long-term behavioural changes in children.

METHODS

The study was conducted between January 2014 and March 2015. Medical records of eligible children were reviewed. Then, parents of children who were included in the study were contacted and asked to visit the Outpatient Department to fill the Eyberg Child Behaviour Inventory questionnaire to measure behavioural changes in children. Children who were exposed to regional or general anaesthesia for surgery between January 2002 and December 2006 were included. Data collected were age and weight at the time of the first anaesthesia exposure and surgery duration. Chi-square test, t-test and multivariate analysis were used.

RESULTS

In total, 394 children were exposed to anaesthesia before the age of 2 years. Among the 168 patients who were exposed to general anaesthesia, 44 children (26.2%) developed behavioural abnormalities compared to 12 out of 226 patients (5.3%) who were exposed to regional anaesthesia (P-value<0.0001). Exposure to anaesthesia before age of 2 years increases the risk of developing behavioural disorder when surgery is accompanied by general anaesthesia, younger age at time of exposure, and longer surgery duration (P-value<0.0001, 0.001, 0.038 respectively).

CONCLUSION

Regional anaesthesia showed much lesser effect on children's behaviour compared to general anaesthesia. The incidence of behavioural disorder is increased with the use of general anaesthesia, younger age of the patient at time of exposure, and longer surgery duration.

摘要

目的

本研究旨在评估 2 岁以下儿童单次全身麻醉与区域麻醉对长期行为变化的影响。

方法

本研究于 2014 年 1 月至 2015 年 3 月进行。回顾了符合条件的儿童的病历。然后,联系了纳入研究的儿童的父母,并邀请他们到门诊部填写 Eyberg 儿童行为清单,以测量儿童的行为变化。纳入了 2002 年 1 月至 2006 年 12 月期间因手术接受局部或全身麻醉的儿童。收集的数据包括首次麻醉暴露和手术持续时间时的年龄和体重。使用卡方检验、t 检验和多变量分析。

结果

共有 394 名儿童在 2 岁前接受过麻醉。在接受全身麻醉的 168 名患者中,有 44 名(26.2%)出现行为异常,而在接受区域麻醉的 226 名患者中,有 12 名(5.3%)出现行为异常(P 值<0.0001)。与区域麻醉相比,2 岁前接受麻醉且手术时伴有全身麻醉、暴露时年龄较小以及手术持续时间较长会增加发生行为障碍的风险(P 值<0.0001、0.001、0.038)。

结论

与全身麻醉相比,区域麻醉对儿童行为的影响较小。使用全身麻醉、暴露时患者年龄较小以及手术持续时间较长,行为障碍的发生率增加。

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