预防全麻患儿苏醒期躁动的证据总结  

Summary of evidence to prevent Emergence Agitation in children undergoing general anesthesia

作　　者：历广招 杨夏 赵旭[1] 安晓华[2] 孙欣[1] 杨丽娟[1] LI Guangzhao;YANG Xia;ZHAO Xu;AN Xiaohua;SUN Xin;YANG Lijuan(Nursing Department,Shandong Provincial Hospital Affiliated to Shandong University,Jinan,250000,China)

机构地区：[1]山东大学附属省立医院护理部,济南市250000 [2]:山东大学附属省立医院麻醉手术科,济南市250000

出　　处：《中国护理管理》2020年第7期1049-1054,共6页Chinese Nursing Management

摘　　要：目的:汇总预防全身麻醉患儿苏醒期躁动的相关证据,为临床提供参考依据。方法:系统检索中国指南网、美国指南网、苏格兰学院间指南网、Up To Date、Joanna Briggs Institute(JBI)循证卫生保健中心数据库、荷兰医学文摘数据库(Embase)、BMJ Best Practice、国际指南图书馆、英国国家临床医学研究所指南库、加拿大安大略注册护士学会网站、护理文献累积索引数据库(CINAHL)、PubMed、Cochrane Library、CBM、CNKI、VIP、万方数据库及麻醉专业协会网站中关于全麻患儿苏醒期躁动预防的所有证据,包括指南、专家共识、证据总结、最佳临床实践手册、系统评价及原始研究等。2名研究者对研究进行质量评价,同时对符合纳入和排除标准的研究进行证据提取。结果:共纳入21篇文献,包括指南3篇、专家共识3篇、系统评价6篇、随机对照试验(RCT)9篇,总结出了14条证据,包括高风险因素评估、术前认知行为干预、围术期情绪调节、减少不良刺激、药物预防5个部分。结论:临床医护人员应定期接受关于苏醒期躁动的知识培训,将证据与医疗条件、患者意愿相结合,制定个体化干预策略,以降低全麻患儿苏醒期躁动的发生率。Objective:To summarize the evidence to prevent Emergence Agitation in children undergoing general anesthesia,and provide reference for clinical practice.Methods:The Chinese Guideline Network,National Guideline Clearinghouse(NGC),Scottish Intercollegiate Guidelines Network(SIGN),Up To Date,Joanna Briggs Institute(JBI),Embase,BMJ Best Practice,Guideline International Network(GIN),National Institute for Health and Care Excellence(NICE),Registered Nurses Association of Ontario(RNAO),CINAHL,Cochrane Library,PubMed,CNKI,VIP,CBM,WAN FANG and anesthesia professional association websites were systematically searched.The evidence on the prevention of Emergence Agitation in children undergoing general anesthesia including guidelines,expert consensus,evidence summary,best practice information sheet,systematic review and original study was collected.Two authors independently assessed the quality of the studies that met the inclusion criteria and extracted data.Results:A total of 21 articles were selected,including 3 guidelines,3 expert consensus,6 systematic reviews and 9 randomized controlled trials.Totally 14 best evidences were summarized,including high risk factors assessment,preoperative cognitive behavior intervention,perioperative mood regulation,adverse stimulation reduction,and drug prevention.Conclusion:The healthcare workers should receive regular training on agitation after the general anesthesia,combine the best evidence with medical condition and patients'intention,to develop individualized intervention strategies in order to reduce the incidence of Emergence Agitation in children undergoing general anesthesia.

关 键 词：全身麻醉 苏醒期躁动 证据总结 

分 类 号：R47[医药卫生—护理学]