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[分析阻塞性睡眠呼吸暂停患儿全身麻醉后严重并发症的原因及预防]

[Analyzing the reasons for and prevention of serious complications after general anesthesia in children with obstructive sleep apnea].

作者信息

Chen Lan, Liu Dabo, Zhong Jianwen, Qiu Shuyao, Zhou Yilong

机构信息

Pediatric Otolaryngology Department of Shenzhen Hospital,Southern Medical University,Shenzhen,518101,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Feb;39(2):168-172. doi: 10.13201/j.issn.2096-7993.2025.02.014.

Abstract

To explore the causes and preventive measures of respiratory arrest following general anesthesia in children with obstructive sleep apnea (OSA), in order to enhance the safety of OSA surgeries under general anesthesia. A retrospective analysis was conducted on the clinical and follow-up data of four pediatric cases that experienced respiratory arrest after general anesthesia for OSA at Shenzhen Hospital of Southern Medical University from March 2020 to March 2022. All four children exhibited varying degrees of decreased blood oxygen saturation, cyanosis, and loss of consciousness after OSA surgery under general anesthesia, with one case experiencing respiratory and cardiac arrest. Through emergency rescue measures such as oxygen supplementation, suctioning, positive pressure ventilation, awakening, and cardiopulmonary resuscitation, all four children were stabilized. Follow-up after 2 to 6 months showed no complications. The main reasons for the occurrence are analyzed as: residual anesthetic drugs, characteristics of the OSA disease, and the unique aspects of the pediatric population. Children undergoing general anesthesia for OSA should be closely monitored for vital signs after surgery. If respiratory suppression occurs, active rescue measures should be taken to avoid serious consequences.

摘要

为探讨阻塞性睡眠呼吸暂停(OSA)患儿全身麻醉后呼吸骤停的原因及预防措施,以提高OSA患儿全身麻醉手术的安全性。对2020年3月至2022年3月在南方医科大学深圳医院接受OSA全身麻醉后发生呼吸骤停的4例儿科病例的临床及随访资料进行回顾性分析。4例患儿在OSA全身麻醉手术后均出现不同程度的血氧饱和度下降、发绀及意识丧失,其中1例出现呼吸和心跳骤停。经吸氧、吸痰、正压通气、唤醒及心肺复苏等急救措施后,4例患儿均病情稳定。术后2至6个月随访未发现并发症。分析其发生的主要原因有:麻醉药物残留、OSA疾病特点及儿童群体的特殊性。OSA患儿全身麻醉术后应密切监测生命体征。若发生呼吸抑制,应积极采取抢救措施,避免严重后果。

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