脑氧饱和度降低增加术后谵妄风险

本文由“小麻哥的日常”授权转载

摘要译文（供参考）

局部脑氧饱和度降低会增加儿童苏醒期谵妄的风险

目标：

评估局部脑氧饱和度降低(regional cerebral oxygen saturation, RSCO2)与儿科人群中全身麻醉后出现苏醒期谵妄(emergence delirium, ED)有关。

方法：

对在2022-01至2022-04期间接受全麻下选择性手术的113名2-14岁儿童(ASA I-III级)进行了回顾性观察队列研究。

术中用脑血氧计监测局部脑氧饱和度，用小儿麻醉苏醒期谵妄量表(Pediatric Anesthesia Emergence Delirium, PAED)评分评估患者是否患有ED。

结果：

ED发生率为31%。

41.6%的患儿出现RSCO2降低，其ED的发生率较未出现局部脑氧饱和度降低患儿的发生率高(P<0.001）。

logistic回归分析显示RSCO2降低与ED事件显著相关[比值比(OR)，10.77；95%可信区间，3.31-35.05]。

麻醉期间RSCO2降低患儿中，3岁以下儿童ED发生率较三岁以上患儿高(OR，14.17vs.4.64)。

结论：

术中RSCO2降低显著增加全麻后ED的发生率。应加强监护，改善重要脏器氧平衡，提高麻醉质量和安全性。

关键字：

儿童；低饱和度；谵妄；全身麻醉；局部脑氧饱和度。

原文摘要

Reduced regional cerebral oxygen saturation increases risk for emergence delirium in pediatric patients

Objectives: 

To assess whether decreased regional cerebral oxygen saturation (rScO2) is associated with the emergence delirium (ED) following general anesthesia in the pediatric population.

Methods: 

A retrospective observational cohort study was conducted on 113 children (ASA I-III) aged 2-14 years who underwent selective surgery under general anesthesia between 2022-01 and 2022-04. 

Intraoperatively, the rScO2 was monitored using a cerebral oximeter.

The Pediatric Anesthesia Emergence Delirium (PAED) score was used to evaluate the patients for ED.

Results: 

The incidence of ED was 31%. 

Low rScO2 was reported in 41.6% of patients, who had a higher incidence of ED (P < 0.001) than those who did not experience desaturation. 

Logistic regression analysis revealed that decreased rScO2 was significantly associated with incident ED events [odds ratio (OR), 10.77; 95% confidence interval, 3.31-35.05]. 

Children under 3 years of age had a higher incidence of ED after rScO2 desaturation during anesthesia compared to older children (OR, 14.17 vs. 4.64).

Conclusion: 

Intraoperative rScO2 desaturation significantly increased the incidence of ED following general anesthesia.

Monitoring should be enhanced to improve the oxygen balance in vital organs to improve the quality and safety of anesthesia.

Keywords: 

children; desaturation; emergence delirium; general anesthesia; regional cerebral oxygen saturation.

免责声明：

文中所涉及药物使用、疾病诊疗等内容仅供医学专业人士参考。

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编辑：MiSuper.米超

校对：Michel.米萱  

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