CAJ | 학술논문

目的研究特殊听觉干预评估小儿术中知晓的准确性.方法择期全麻下行脊柱侧弯后路矫形术的患儿34例,年龄5～15岁,体重16～73kg,ASA分级Ⅰ或Ⅱ级.于麻醉诱导前和术中唤醒结束后,通过耳机各给予1次不同的特殊听觉干预(60 dB,15s).于术后24 h内和术后5～7 d时对患儿进行访视,判定患儿对术中唤醒和特殊听觉干预的知晓情况.结果 34例患儿中3例因唤醒后躁动、1例因对访视产生厌恶情绪而排除.30例患儿中3例发生了确证唤醒知晓,1例为可疑唤醒知晓,术中唤醒知晓率为10%,但4例患儿中只有1例对术中特殊听觉干预发生知晓.30例患儿均能准确回忆起于麻醉诱导前给予的特殊听觉干预.结论特殊听觉干预并不能准确地评估脊柱侧弯后路矫形手术患儿术中知晓的发生情况.
목적 연구특수은각간예평고소인술중지효적준학성.방법 택기전마하행척주측만후로교형술적환인34례,년령5～15세,체중16～73kg,ASA분급Ⅰ혹Ⅱ급.우마취유도전화술중환성결속후,통과이궤각급여1차불동적특수은각간예(60 dB,15s).우술후24 h내화술후5～7 d시대환인진행방시,판정환인대술중환성화특수은각간예적지효정황.결과 34례환인중3례인환성후조동、1례인대방시산생염악정서이배제.30례환인중3례발생료학증환성지효,1례위가의환성지효,술중환성지효솔위10%,단4례환인중지유1례대술중특수은각간예발생지효.30례환인균능준학회억기우마취유도전급여적특수은각간예.결론 특수은각간예병불능준학지평고척주측만후로교형수술환인술중지효적발생정황.
Objective To determine the feasibility of using a special auditory intervention to detect intraoperative awareness in children under general anesthesia. Methods Thirty-four ASA Ⅰ or Ⅱ children aged 5-15 yr weighing 16-73 kg undergoing scoliosis were enrolled in this study.Intraoperative wake-up test was performed during operation.Two easily identified animal noises(60 dB,lasting 15 s)were played through head phones before induction of anesthesia and immediately after the intraoperative wake-up test. Children were interviewed on the 1st and 5th-7th days after surgery to assess their awareness of intraoperative wake-up test and special auditory intervention. Results Four children were excluded from the study because of restlessness during the intraoperative wake-up test or their refusal to be interviewed. From the remaining 30 children,4 children were suspected to be aware of intraooperative wake-up test. Awareness was comfirmed in 3 children and suspected in one child.The incidence of awareness of intraoperative wake-up test was 10%.But only one of them could tell the animal sound played during the wake-up test.All the patients in this study had explicit recall of the animal noises played before induction of anesthesia.Conclusion Special auditory intervention can not detect intraoperative awareness in children unnder general anesthesia.