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择期整形手术患儿术后早期低氧血症的观察

Observation of early postoperative hypoxaemia in children undergoing elective plastic surgery.

作者信息

Xue F S, Huang Y G, Luo L K, Deng X M, Liao X, Tong S Y, Liu Q H

机构信息

Department of Anaesthesiology, Chinese Academy of Medical Sciences, Beijing.

出版信息

Paediatr Anaesth. 1996;6(1):21-8. doi: 10.1111/j.1460-9592.1996.tb00347.x.

Abstract

The incidence, severity and duration of early postoperative hypoxaemia were determined in 420 healthy infants and children undergoing elective plastic surgery. Mean value of preoperative SpO2 was 98.3 +/- 0.87%. However, it decreased significantly to 92.7 +/- 4.01% immediately following anaesthesia in the postanaesthesia recovery room (PAR) when children breathed room air. Then SpO2 gradually increased to 93.8 +/- 4.25% at 10 min, 95.4 +/- 3.14% at 30 min, 96.6 +/- 2.25% at 60 min, 96.9 +/- 1.69% at 120 min, and 97.4 +/- 1.55% at 180 min, respectively. The incidence of hypoxaemia and severe hypoxaemia, which were 14.8% and 6.2% respectively on arrival in the PAR, decreased significantly to 6.6% and 1.9%, 30 min later. The hypoxaemia occurred most commonly within 1 h, particularly the first 30 min following anaesthesia. The hypoxaemia was more common and more severe in children undergoing cleft palate repair than other kinds of plastic surgery. A significant correlation was found between low SpO2 levels on admission to the PAR and children's age, fentanyl doses, and the infants' recovery score.

摘要

对420例接受择期整形手术的健康婴幼儿及儿童,测定了术后早期低氧血症的发生率、严重程度及持续时间。术前SpO2的平均值为98.3±0.87%。然而,在麻醉后恢复室(PAR),当患儿呼吸室内空气时,麻醉后SpO2立即显著降至92.7±4.01%。随后SpO2逐渐上升,在10分钟时为93.8±4.25%,30分钟时为95.4±3.14%,60分钟时为96.6±2.25%,120分钟时为96.9±1.69%,180分钟时为97.4±1.55%。低氧血症和严重低氧血症的发生率在到达PAR时分别为14.8%和6.2%,30分钟后显著降至6.6%和1.9%。低氧血症最常发生在1小时内,尤其是麻醉后的前30分钟。与其他类型的整形手术相比,腭裂修复手术患儿的低氧血症更常见且更严重。在进入PAR时的低SpO2水平与患儿年龄、芬太尼剂量及婴儿恢复评分之间存在显著相关性。

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