不同诱导方式对学龄前儿童苏醒期躁动及其家属手术等待期间焦虑水平的影响  

Effect of different anesthesia inductions on the emergence delirium of preschool children and the anxiety level of their parents during operation

作　　者：谢永果[1] 杜学柯[1] 陈丽妮[1] 邱行[1] 蒋小青[1] 明少鹏 XIE Yongguo;DU Xueke;CHEN Li′ni;QIU Hang;JIANG Xiaoqing;MING Shaopeng(Department of Anesthesiology,the Second Affiliated Hospital of Guangxi Medical University,Guangxi Zhuang Autonomous Region,Nanning530007,China)

机构地区：[1]广西医科大学第二附属医院麻醉科,广西南宁530007

出　　处：《中国医药导报》2020年第22期98-100,105,共4页China Medical Herald

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20181016、Z20181017)。

摘　　要：目的探讨不同诱导方式对学龄前儿童苏醒期躁动及其家属手术等待期间焦虑水平的影响。方法选择2018年7月—2019年3月广西医科大学第二附属医院拟全麻下行包皮环切术患儿60例及其家属60名为研究对象,采用随机数字表法将其分为K组(30例)和S组(30例)。K组进入手术室前肌肉注射氯胺酮进行麻醉诱导;S组进入手术室后面罩吸入6%七氟醚+氧气进行麻醉诱导。比较两组患儿改良耶鲁术前焦虑评分量表(m-YPAS)评分,合作度量表(ICC)评分,小儿麻醉苏醒躁动评分量表(PAED)评分及改良加拿大东安大略儿童医院疼痛评分量表(m-CHEOPS)评分;比较两组患儿家属特质焦虑量表(T-AI)评分及状态焦虑量表(S-AI)评分。结果两组患儿m-YPAS评分、m-CHEOPS评分比较,差异无统计学意义(P>0.05);S组患儿ICC评分、PAED评分低于K组(均P<0.05)。两组患儿家属T-AI评分比较,差异无统计学意义(P>0.05);S组S-AI评分低于K组(P<0.05)。ICC评分与S-AI评分及PAED评分呈正相关(r=0.450、0.439,P=0.004、0.005);PAED评与及S-AI评分呈正相关(r=0.518,P=0.001)。结论与肌肉注射氯胺酮比较,吸入七氟醚诱导能有效降低患儿诱导期ICC评分、术后PAED评分,降低患儿家属手术等待期间的焦虑水平。Objective To investigate the effect of different anesthesia inductions on the emergence delirium of preschool children and the anxiety level of their parents during operation.Methods From July 2018 to March 2019,60 cases of children and their families to be circumcised under general anesthesia in the Second Affiliated Hospital of Guangxi Medical University were selected as study subjects.According to random number table method,they were divided into group K(30 cases)and group S(30 cases).Group K received intramuscular Ketamine for anesthesia induction before entering the operating room.Group S was included in anesthesia induction by inhaling 6%Sevoflurane+oxygen by mask after operating room.The modified Yale preoperative anxiety scale(M-YPAS),induction compliance checklist(ICC)scale,pediatric anesthesia emergence delirium(PAED)scale and modified children′s hospital of Eastern Ontario pain scale(m-CHEOPS)were compared between two groups.Scores of patients′parents trait anxiety inventory(T-AI)scale and state anxiety inventory(S-AI)scale between two groups were compared.Results There were no significant differences in children′s m-YPAS score,m-CHEOPS score(P>0.05);ICC score and PAED score in group S were lower than those in group K(all P<0.05).There was no significant difference in T-AI score of patients′parents(P>0.05);and S-AI score of Group S was lower than that of group K(P<0.05).ICC scores were positively correlated with S-AI scores and PAED scores(r=0.450,0.439,P=0.004,0.005).PAED scores were positively correlated with S-AI scores(r=0.518,P=0.001).Conclusion Compared with intramuscular Ketamine,induction with Sevoflurane is effective in reducing induction period ICC scores and post-operative PAED scores,as well as reduce anxiety levels in the families during the waiting period for surgery.

关 键 词：小儿麻醉 学龄前儿童 苏醒期躁动 家属焦虑水平 

分 类 号：R726.1[医药卫生—儿科]