不同年龄段儿童七氟烷麻醉术后躁动的临床观察

目的比较不同年龄段儿童吸入七氟烷全身麻醉术后躁动的发生情况以及对相关因素的探讨分析。方法90例ASAⅠ～Ⅱ级择期行颌面整形手术患儿,按年龄段分成三组:Ⅰ组即婴儿组(2月～1岁);Ⅱ组即学龄前组(2～5岁);Ⅲ组即学龄组(6-10岁)。各组麻醉维持均单纯吸入七氟烷。观察各组术后躁动的发生率、持续时间以及恶心、呕吐等并发症。结果Ⅰ、Ⅱ、Ⅲ组均有术后躁动发生,Ⅱ组发生率及持续时间分别为56.7%、11.2±8.4min高于Ⅰ组的33.3%、5.2±3.7min和Ⅲ组的36.7%、5.7±3.5min(P<0.05)。躁动患儿中有5例发生恶心、呕吐。结论与婴儿和学龄儿童相比,学龄前儿童在吸入七氟烷全身麻醉下行颌面整形手术后更易发生术后躁动,因此针对儿童麻醉个性化反应,对其围手术期麻醉应进一步合理完善。

Postoperative Agitation in Pediatric Patients of Diferrent Stage after Sevoflurane Anesthesia

Objective To compare the incidence and evaluate factors associated with emergence agitation(EA) in pediatric patients of diferrent stage following sevoflurane anesthesia for maintenance.Methods 90 pediatric patients undergoing craniofacial orthopedics surgery,American Society of Anesthesiologists ASA] I or II,were divided into 3 groups,group Ⅰ :infants(2 month-1year);group Ⅱ :preschool-aged children(2-5years);groupⅢ:school-aged children(6-10years).All patients only inhaled sevoflurane for maintenance.We compared the incidence of EA with an average duration and recorded adverse effects(nausea,vomiting etc).Results GroupⅡappeared more incidence with longer time than group I or Ⅲ(56.7%、 11.2±8.4min vs33.3%、 5.2±3.7min;36.7%、 5.7±3.5min).Conclusoin Preschool children have higher chance of emer gence agitation after sevoflurane anesthesia,compared with infants and shool-aged children.Therefore,anesthesia personnel responsible for pedia tric anesthesia should have the better methods that minimize incidence of EA.