CAJ | 학술논문

目的探讨学龄前儿童全麻后苏醒期躁动(EA)的相关危险因素.方法选择浙江省中西医结合医院麻醉科2008年1月至2011年10月间268例2～9岁的住院儿童,均在全身麻醉(全麻)下接受不同类型手术,统计在麻醉后恢复室(PACU)EA的发生率,记录患儿术前能否与父母分开、药理学及非药理学治疗方法及相关不良事件.单因素及多因素分析与EA发生可能相关的危险因素.结果 116例患儿(43.3％)在PACU发生EA,持续时间为(9±7) min,其中有35例(30.2％)并发了与EA相关的不良事件.单因素分析发现EA发生的相关因素是难以与父母分开、学龄前期(2～5岁)及七氟烷麻醉,但经多因素Logistic回归分析后只有难以与父母分开[OR =3.091 (95％CI:1.688,5.456,P＜0.01)]及学龄前期[OR=1.965(95％ CI:1.112,3.318,P=0.024)]这两个因素是EA的危险因素.结论在PACU小儿全麻后EA高发,难以与父母分开及学龄前期是EA的预测因素.
목적 탐토학령전인동전마후소성기조동(EA)적상관위험인소.방법 선택절강성중서의결합의원마취과2008년1월지2011년10월간268례2～9세적주원인동,균재전신마취(전마)하접수불동류형수술,통계재마취후회복실(PACU)EA적발생솔,기록환인술전능부여부모분개、약이학급비약이학치료방법급상관불량사건.단인소급다인소분석여EA발생가능상관적위험인소.결과 116례환인(43.3％)재PACU발생EA,지속시간위(9±7) min,기중유35례(30.2％)병발료여EA상관적불량사건.단인소분석발현EA발생적상관인소시난이여부모분개、학령전기(2～5세)급칠불완마취,단경다인소Logistic회귀분석후지유난이여부모분개[OR =3.091 (95％CI:1.688,5.456,P＜0.01)]급학령전기[OR=1.965(95％ CI:1.112,3.318,P=0.024)]저량개인소시EA적위험인소.결론 재PACU소인전마후EA고발,난이여부모분개급학령전기시EA적예측인소.
Objective To evaluate risk factors associated with emergence agitation (EA) in pediatrics after general anesthesia.Methods A prospective cohort study was conducted in 268 pediatric patients aged 2 -9 years,who received general anesthesia for various operative procedures in our hospital between January 2008 and October 2011.The incidence of EA was assessed.Difficult parental-separation behavior,pharmacologic and non-pharmacologic interventions,and adverse events were also recorded.Univariate and multivariate analysis were used to determine the factors associated with EA.A p-value of less than 0.05 was considered significant.Results One hundred and sixteen children (43.3％) had EA,with an average duration of 9.1 ± 6.6 minutes.EA associated with adverse events occurred in 35 agitated children (30.2％ ).From univariate analysis,factors associated with EA were difficult parental-separation behavior,preschool age (2 -5 years),and general anesthesia with sevoflurane.However,difficult parental-separation behavior,and preschool age were the only factors significantly associated with EA in the multiple Logistic regression analysis with OR =3.091 (95％ CI:1.688,5.465,P ＜ 0.01 ) and OR =1.965 (95％ CI:1.112,3.318,P =0.024),respectively.Conclusion The present study indicated that the incidence of EA was high in PACU.Preschool children and difficult parental-separation behavior were the predictive factors of emergence agitation.