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术后丙泊酚推注治疗对斜视手术患儿七氟醚麻醉后苏醒期躁动患者的苏醒时间无影响:前瞻性非随机病例对照研究。

Postoperative propofol bolus treatment did not affect recovery time in patients with emergence agitation after sevoflurane anesthesia in pediatric patients undergoing strabismus surgery: Prospective nonrandomized case-control study.

机构信息

Department of Anesthesiology and Pain Medicine, College of Medicine, Graduate School Korea University, Seoul, Republic of Korea.

Department of Anesthesiology and Pain Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.

出版信息

Medicine (Baltimore). 2022 Jul 15;101(28):e29521. doi: 10.1097/MD.0000000000029521.

DOI:10.1097/MD.0000000000029521
PMID:35838993
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11132384/
Abstract

BACKGROUND

The incidence of emergence agitation (EA) after sevoflurane anesthesia is high, especially in pediatric strabismus surgery. However, research thus far has focused on the pharmacological prophylaxis of EA and administering drugs to pediatric patients without EA is problematic. The purpose of this study was to determine whether the use of propofol after sevoflurane anesthesia affects recovery time in patients with EA.

METHODS

After obtaining informed written consent, 113 children (aged 2-12 years) with the American Society of Anesthesiologists physical status of I or II who underwent strabismus surgery were enrolled. Patients were divided into 2 groups; upon arrival at the postanesthetic care unit (PACU), patients who had EA (pediatric anesthesia emergence delirium [PAED] scale score ≥14) were treated with 1.0 mg/kg 1% propofol (group P: n = 30). Patients who did not have EA (PAED scale score <14, group C: n = 83) were taken care of in the PACU without propofol administration.

RESULTS

There was no difference in the PAED scale scores between the 2 groups from 10 minutes to discharge from the PACU (P > .05). There was no difference in PACU stay time between the 2 groups (P > .05).

CONCLUSIONS

We concluded that propofol administration for intense EA alleviated EA symptoms and prevented an increase in the duration of PACU stay due to EA in children undergoing strabismus surgery under sevoflurane anesthesia.

摘要

背景

七氟醚麻醉后出现苏醒期躁动(EA)的发生率较高,尤其是在小儿斜视手术中。然而,迄今为止的研究主要集中在 EA 的药物预防上,给没有 EA 的小儿患者用药存在问题。本研究旨在确定七氟醚麻醉后使用丙泊酚是否会影响 EA 患者的恢复时间。

方法

在获得知情书面同意后,纳入了 113 名接受斜视手术且美国麻醉医师协会身体状况为 I 级或 II 级的 2-12 岁儿童患者。患者被分为 2 组;在到达麻醉后恢复室(PACU)时,出现 EA(小儿麻醉苏醒期谵妄量表[PAED]评分≥14)的患者给予 1.0mg/kg 1%丙泊酚(P 组:n=30)。没有 EA(PAED 量表评分<14,C 组:n=83)的患者在 PACU 中接受常规护理,不给予丙泊酚。

结果

从 10 分钟到 PACU 出院,2 组之间的 PAED 量表评分无差异(P>.05)。2 组 PACU 停留时间无差异(P>.05)。

结论

我们的结论是,在接受七氟醚麻醉的斜视手术小儿患者中,对于严重 EA 给予丙泊酚可缓解 EA 症状,并防止因 EA 而导致 PACU 停留时间延长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5dc/11132384/4f5fc22d6717/medi-101-e29521-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5dc/11132384/4d435f7bbf43/medi-101-e29521-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5dc/11132384/4f5fc22d6717/medi-101-e29521-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5dc/11132384/4d435f7bbf43/medi-101-e29521-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5dc/11132384/4f5fc22d6717/medi-101-e29521-g002.jpg

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本文引用的文献

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Use of propofol and emergence agitation in children: a literature review.丙泊酚在儿童中的应用及苏醒期躁动:文献综述
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Emergence agitation in adults: risk factors in 2,000 patients.成人术后躁动:2000 例患者的危险因素。
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Risk factors for inadequate emergence after anesthesia: emergence delirium and hypoactive emergence.麻醉后苏醒不充分的危险因素:苏醒谵妄和低反应性苏醒。
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Greater incidence of emergence agitation in children after sevoflurane anesthesia as compared with halothane: a meta-analysis of randomized controlled trials.与氟烷相比,七氟醚麻醉后儿童出现苏醒期躁动的发生率更高:一项随机对照试验的荟萃分析。
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Effect of propofol on emergence behavior in children after sevoflurane general anesthesia.丙泊酚对七氟醚全身麻醉后儿童苏醒行为的影响。
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