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多次全身麻醉对中国北京整形外科手术后儿童睡眠质量的影响:一项队列研究。

Effects of multiple exposures to general anesthesia on the sleep quality of children after plastic surgery in Beijing, China: a cohort study.

作者信息

Wang Ye, Liu Juhui, Jin Zibin, Li Weiou, Wei Lingxin, Yang Dong, Deng Xiaoming, Yan Fuxia

机构信息

Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Ba-da-chu Rd., Shijingshan District, Beijing, 100144 China.

Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 North-li-shi Rd., Xicheng District, Beijing, 100037 China.

出版信息

Sleep Biol Rhythms. 2022 Jun 17;20(4):509-519. doi: 10.1007/s41105-022-00397-2. eCollection 2022 Oct.

Abstract

To assess the effects of the number and duration of general anesthesia exposure on the sleep quality of 6-15-year-old school children who underwent plastic surgery. The study was conducted on 688 children who underwent plastic surgery between the ages of 6 and 15 years using the Sleep Disorder Scale for Children (SDSC). The children were divided into two groups according to their exposure to general anesthesia: No General Anesthesia (NGA) and General Anesthesia (GA) groups. The GA group was further divided into three subgroups according to the number of exposures: Single-exposure, Double-exposure, and Multiple-exposure groups. The GA group was also subdivided into two groups according to the cumulative total time of anesthesia exposure: < 3 h and ≥ 3 h groups. Multivariate logistic regression analysis was used to confirm the potential factors that affect children with sleep disturbance (SDSC scores > 39) after general anesthesia exposure. Linear regression was used to analyze the correlation of the factors with the SDSC scores. The SDSC scores were higher in the GA group [35.4 ± 4.3 vs. 34.0 ± 3.6,  < 0.0001] as compared to the NGA group. The number of children with SDSC scores > 39 was also higher in the GA group [80 (17.5%) vs. 17 (7.4%),  < 0.0001]. More anesthesia exposure was correlated with higher total SDSC scores [34.5 ± 4.3 for single exposure vs 35.1 ± 3.9 for double exposure vs 37.5 ± 4.5 for multiple exposures,  < 0.0001] and a higher proportion of SDSC scores > 39 [24 (12.0%) for single exposure vs 24 (15.5%) for double exposure vs 32 (31.1%) for multiple exposures,  < 0.0001]. Longer anesthesia exposure was also correlated with higher total SDSC scores [34.4 ± 4.5 for < 3 h vs. 35.8 ± 4.2 for ≥ 3 h,  = 0.002]. The number of exposures to general anesthesia was a potential factor in sleep disturbance among children, determined based on logistic regression. Children who underwent plastic surgery between the ages of 6 and 15 years with general anesthesia exposure might have worse sleep quality and a higher incidence of sleep disorders. More frequent anesthesia exposure leads to worsened sleep quality and a higher incidence of sleep disorders. This study also confirmed that a longer duration of cumulative anesthesia exposure also leads to worse sleep quality.

摘要

评估全身麻醉暴露次数和时长对6至15岁接受整形手术的学龄儿童睡眠质量的影响。本研究对688名年龄在6至15岁之间接受整形手术的儿童使用儿童睡眠障碍量表(SDSC)进行。根据全身麻醉暴露情况将儿童分为两组:无全身麻醉(NGA)组和全身麻醉(GA)组。GA组根据暴露次数进一步分为三个亚组:单次暴露、两次暴露和多次暴露组。GA组还根据麻醉暴露累计总时长分为两组:<3小时组和≥3小时组。采用多因素逻辑回归分析确定全身麻醉暴露后影响睡眠障碍儿童(SDSC评分>39)的潜在因素。采用线性回归分析这些因素与SDSC评分的相关性。与NGA组相比,GA组的SDSC评分更高[35.4±4.3 vs. 34.0±3.6,<0.0001]。GA组中SDSC评分>39的儿童数量也更多[80(17.5%)vs. 17(7.4%),<0.0001]。更多的麻醉暴露与更高的SDSC总分相关[单次暴露为34.5±4.3,两次暴露为35.1±3.9,多次暴露为37.5±4.5,<0.0001],以及更高比例的SDSC评分>39[单次暴露为24(12.0%),两次暴露为24(15.5%),多次暴露为32(31.1%),<0.0001]。更长的麻醉暴露时间也与更高的SDSC总分相关[<3小时为34.4±4.5,≥3小时为35.8±4.2,=0.002]。根据逻辑回归确定,全身麻醉暴露次数是儿童睡眠障碍的一个潜在因素。6至15岁接受整形手术且有全身麻醉暴露的儿童可能睡眠质量更差,睡眠障碍发生率更高。更频繁的麻醉暴露会导致睡眠质量恶化和睡眠障碍发生率更高。本研究还证实,累计麻醉暴露时间越长也会导致睡眠质量越差。

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