Department of Anesthesiology, Hokkaido P.W.F.A.C. Obihiro Kosei General Hospital, Obihiro, Hokkaido 080-0024, Japan.
Department of Anesthesiology, Hokkaido Medical Center for Child Health and Rehabilitation, Hokkaido, Japan.
Ann Card Anaesth. 2020 Oct-Dec;23(4):433-438. doi: 10.4103/aca.ACA_69_19.
Emergence agitation for pediatric patients after general anesthesia is one of the postoperative complications. The relationship between consciousness at tracheal extubation and emergence agitation is not clear.
The aim of the present study was to determine whether tracheal extubation of anesthetized pediatric patients with heart disease by propofol decreases the incidence of emergence agitation.
This was a retrospective case-control study conducted at a children's hospital. Materials and Methods: Pediatric patients with heart disease aged 0-14 years who underwent cardiac catheterization under general anesthesia by propofol between October 2014 and September 2018 were enrolled. The incidence of emergence agitation by anesthetized extubation was compared with that by awake extubation.
Logistic regression analysis was performed.
Anesthetized extubation was performed in 202 patients and awake extubation was performed in 56 patients. The incidence of emergence agitation was significantly lower in patients who underwent anesthetized extubation than in patients who underwent awake extubation (25.2% vs. 69.6%, P = 0.000). In logistic regression analysis, anesthetized extubation [odds ratio (OR): 0.075, 95% confidence interval (CI): 0.034-0.165, P = 0.000] and older age (OR: 0.808, 95% CI: 0.728-0.897, P = 0.000) were associated with a decreased incidence of emergence agitation, and preoperative anxiety (OR: 2.220, 95% CI: 1.060-4.660, P = 0.03) was associated with an increased incidence of emergence agitation.
Tracheal extubation under anesthesia by propofol decreases the incidence of emergence agitation in pediatric patients with heart disease.
全麻后小儿患者出现苏醒期躁动是术后并发症之一。气管拔管时的意识状态与苏醒期躁动的关系尚不清楚。
本研究旨在确定心脏病患儿在全身麻醉下使用异丙酚进行气管拔管是否会降低苏醒期躁动的发生率。
这是一项在儿童医院进行的回顾性病例对照研究。
纳入 2014 年 10 月至 2018 年 9 月期间在全身麻醉下使用异丙酚行心脏导管术的 0-14 岁心脏病患儿。比较麻醉拔管和清醒拔管时的苏醒期躁动发生率。
采用 logistic 回归分析。
202 例患者行麻醉拔管，56 例患者行清醒拔管。麻醉拔管患者苏醒期躁动发生率明显低于清醒拔管患者（25.2% vs. 69.6%，P=0.000）。logistic 回归分析显示，麻醉拔管[比值比（OR）：0.075，95%置信区间（CI）：0.034-0.165，P=0.000]和年龄较大（OR：0.808，95%CI：0.728-0.897，P=0.000）与苏醒期躁动发生率降低相关，而术前焦虑（OR：2.220，95%CI：1.060-4.660，P=0.03）与苏醒期躁动发生率增加相关。
心脏病患儿在全身麻醉下进行气管拔管可降低苏醒期躁动的发生率。
