扁桃体切除术和腺样体切除术患儿出现谵妄的患病率。
Prevalence of Emergence Delirium in Children Undergoing Tonsillectomy and Adenoidectomy.
作者信息
Liu Katie, Liu Christopher, Ulualp Seckin O
机构信息
Department of Anesthesiology and Pain Management, Division of Pediatric Anesthesiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Otolaryngology-Head and Neck Surgery, Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
Anesthesiol Res Pract. 2022 Sep 28;2022:1465999. doi: 10.1155/2022/1465999. eCollection 2022.
OBJECTIVE
Emergence delirium (ED) is associated with behavioral disturbances and psychomotor agitation, increased risk of selfinjury, delayed discharge, and parental dissatisfaction with quality of care. Otolaryngology procedures are associated with an increased risk of ED. The aims of this study were to determine the prevalence of ED in children who had tonsillectomy and adenoidectomy (T&A), assess the characteristics of children who had ED, and ascertain the recovery times of patients with ED.
METHODS
Charts of patients who had tonsillectomy and adenoidectomy between Jan 1, 2018 and March 26, 2020 at a tertiary children's hospital were reviewed. Data collection included demographics, body mass index, indication for T&A, Pediatric Anesthesia Emergence Delirium (PAED) score, American Society of Anesthesiologists (ASA) physical status classification, total anesthesia time, postanesthesia care phase I time, and postanesthesia care phase II time.
RESULTS
Of the 4974 patients who underwent T&A, ED occurred in 1.3% of patients. Toddlers (2.9%) and male children (1.6%) had a significantly higher prevalence of ED. Prevalence of ED was similar amongst patients with recurrent tonsillitis, patients with obstructive sleep disordered breathing, and patients with both obstructive sleep apnea (OSA) and recurrent tonsillitis. The prevalence of ED was not different amongst ASA I, ASA II, and ASA III. Males with ED had longer total anesthesia times (41 . 34 minutes, =0.02) and ASA I patients with ED had longer phase I times (=0.04) in the postanesthesia care unit (PACU). There was no significant difference in total anesthesia time, phase I time, or phase II time when compared across the subgroups of gender, age, indication for T&A, severity of obstructive sleep apnea (OSA), and ASA score.
CONCLUSIONS
Males, toddlers, and preschool-age children were more likely to have ED. Males with ED had longer total anesthesia times. ED was associated with longer phase I times in ASA I patients.
目的
苏醒期谵妄（ED）与行为障碍、精神运动性激越、自伤风险增加、出院延迟以及家长对护理质量的不满有关。耳鼻喉科手术与ED风险增加相关。本研究的目的是确定接受扁桃体切除术和腺样体切除术（T&A）的儿童中ED的患病率，评估发生ED的儿童的特征，并确定ED患者的恢复时间。
方法
回顾了一家三级儿童医院在2018年1月1日至2020年3月26日期间接受扁桃体切除术和腺样体切除术的患者的病历。数据收集包括人口统计学资料、体重指数、T&A的指征、小儿麻醉苏醒期谵妄（PAED）评分、美国麻醉医师协会（ASA）身体状况分类、总麻醉时间、麻醉后护理I期时间和麻醉后护理II期时间。
结果
在4974例接受T&A的患者中，1.3%的患者发生了ED。幼儿（2.9%）和男性儿童（1.6%）的ED患病率显著更高。复发性扁桃体炎患者、阻塞性睡眠呼吸障碍患者以及同时患有阻塞性睡眠呼吸暂停（OSA）和复发性扁桃体炎的患者中ED的患病率相似。ASA I、ASA II和ASA III患者中ED的患病率没有差异。发生ED的男性总麻醉时间更长（41.34分钟，P = 0.02），而在麻醉后护理单元（PACU）中，发生ED的ASA I患者I期时间更长（P = 0.04）。在按性别、年龄、T&A指征、阻塞性睡眠呼吸暂停（OSA）严重程度和ASA评分划分的亚组中，总麻醉时间、I期时间或II期时间相比无显著差异。
结论
男性、幼儿和学龄前儿童更易发生ED。发生ED的男性总麻醉时间更长。ED与ASA I患者更长的I期时间有关。
Zotero 插件