儿童神经外科麻醉苏醒期谵妄和躁动的危险因素分析  

Analysis of risk factors of delirium and agitation during anesthesia emergence in pediatric neurosurgery patients

作　　者：王成尉[1] 袁琳淞 周扬 王会文[1] Wang Chengwei;Yuan Linsong;Zhou Yang;Wang Huiwen(Department of Anaesthesiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京天坛医院麻醉科,北京100050

出　　处：《首都医科大学学报》2023年第2期244-247,共4页Journal of Capital Medical University

基　　金：北京市科委科技计划项目(Z19110700660000)。

摘　　要：目的 探讨神经外科患儿麻醉苏醒期谵妄和躁动的影响因素。方法 回顾性调查512例神经外科手术患儿的临床资料,其中苏醒期谵妄躁动组120例,经匹配对照组392例。采用多因素Logistic回归分析检验神经外科患儿麻醉苏醒期发生谵妄和躁动的影响因素。结果 多因素Logistic回归分析显示,术前口服咪达唑仑(OR=2.695,95%CI:1.183~6.139,P=0.018)、术中应用右美托咪定(OR=0.210,95%CI:0.049~0.902,P=0.036)和复合吸入麻醉(OR=2.862,95%CI:1.300~6.301,P=0.009)是神经外科患儿麻醉恢复期发生谵妄和躁动的影响因素。结论 入手术室前口服咪达唑仑、复合吸入麻醉方法是发生谵妄和躁动的独立危险因素,麻醉维持应用右美托咪定可降低谵妄和躁动发生。Objective To explore the risk factors of delirium and agitation in pediatric neurosurgery patients during anesthesia emergency.Methods The clinical data of pediatric neurosurgery patients were retrospectively investigated with 120 cases in the delirium and agitation group,and 392 cases in the matched control group.Multivariate Logistic regression analysis was used to explore the risk factors of delirium and agitation in pediatric neurosurgery patients during anesthesia emergency.Results Multivariate Logistic regression analysis showed that oral midazolam before operation(OR=2.695,95%CI:1.183-6.139,P=0.018),intraoperative infusion of dexmedetomidine(OR=0.210,95%CI:0.049-0.902,P=0.036)and combined inhalation anesthesia(OR=2.862,95%CI:1.300-6.301,P=0.009)were the risk factors of delirium and agitation in pediatric neurosurgery patients during anesthesia emergency.Conclusion Oral midazolam before entering the operating room and combined inhalation anesthesia are independent risk factors for delirium and agitation,and dexmedetomidine can reduce the occurrence of delirium and agitation for pediatric neurosurgery patients.

关 键 词：神经外科儿童 谵妄和躁动 麻醉苏醒期 危险因素 

分 类 号：R614[医药卫生—麻醉学]