Cui Yu, Wu Qunying, Tang Min, Chen Qin, Kang Lu, Mu Qixia, He Yani
Department of Anesthesiology, The Affiliated Hospital, School of Medicine, UESTC Chengdu Women's & Children's Central Hospital, Chengdu, China.
Front Med (Lausanne). 2024 Oct 11;11:1466205. doi: 10.3389/fmed.2024.1466205. eCollection 2024.
Sedation-related adverse events not only referred to a cause for morbidity and mortality but also included events that could disrupt routine procedures and thus lead to reduced procedural efficiency or quality. To date, no literature is available to predict the risk factors associated with prolonged recovery in pediatric patients during procedural sedation. Thus, we retrospectively analyzed the two-year sedation data to explore the above questions.
Pediatric patients who underwent procedural sedation between January 2022 and January 2024 were retrospectively analyzed. The patients were divided into two groups according to sedation duration <120 min (Non-prolonged recovery group); or ≧ 120 min (Prolonged recovery group). The primary outcome was the incidence of prolonged recovery. Risk factors associated with prolonged recovery were assessed.
A total of 30,003 patients were identified; 854 (2.8%) developed prolonged recovery during procedural sedation. By multivariate regression, a higher body weight (OR 1.03, 95%CI 1.01-1.05), outpatients (OR 1.31, 95%CI 1.07-1.59), patients with sedation history (OR 1.25, 95%CI 1.07-1.44), and patients received chloral hydrate (OR 1.47, 95%CI 1.06-2.03), were associated with increased odds of the prolonged recovery with the initial sedative(s).
Monitoring time needs to be extended in patients with sedation history, those with heavier weights, outpatients, and those who received chloral hydrate.
镇静相关不良事件不仅是发病和死亡的原因，还包括可能扰乱常规操作从而导致操作效率或质量降低的事件。迄今为止，尚无文献可用于预测小儿患者在操作镇静期间与恢复时间延长相关的危险因素。因此，我们回顾性分析了两年的镇静数据以探讨上述问题。
对2022年1月至2024年1月期间接受操作镇静的小儿患者进行回顾性分析。根据镇静持续时间<120分钟（非延长恢复组）或≥120分钟（延长恢复组）将患者分为两组。主要结局是延长恢复的发生率。评估与延长恢复相关的危险因素。
共纳入30003例患者；854例（2.8%）在操作镇静期间出现恢复时间延长。通过多因素回归分析，较高的体重（OR 1.03，95%CI 1.01-1.05）、门诊患者（OR 1.31，95%CI 1.07-1.59）、有镇静史的患者（OR 1.25，95%CI 1.07-1.44）以及接受水合氯醛的患者（OR 1.47，95%CI 1.06-2.03），与初始镇静剂使用后恢复时间延长的几率增加相关。
对于有镇静史、体重较重、门诊患者以及接受水合氯醛的患者，需要延长监测时间。
