小儿全麻术后谵妄研究进展

谵妄(Emergence Delirium,ED)是一种复杂的感知障碍和精神躁动,最常发生于学龄前儿童麻醉后早期,其病因目前并不十分清楚。术语ED常与躁动(Emergence Agitation,EA)及麻醉后兴奋(Postanesthetic Excitement,PE)交替使用。可能与年龄、挥发性麻醉药物、围术期焦虑、疼痛有关。2岁以下小儿谵妄可以用PAED量表精确诊断,但也有其局限性。主要从防止术前焦虑、术后镇痛和术中丙泊酚、右美托咪啶的应用进行预防;恢复室治疗可以应用丙泊酚、右美托咪啶和硫酸镁。本文总结了小儿手术后谵妄的最新进展,通过对小儿术后谵妄的研究,完善小儿术后谵妄的管理,减少并发症,以期为小儿谵妄的诊断、治疗、预防提供了良好依据。

The Progress of Postoperative Emergence Delirium in Pediatric Patients

ABSTRACT: Emergence Delirium (ED) is a complex cognitive disorder and mental restlessness. It occurs most frequently in preschool children after anesthesia. Its etiology is not very clear at present. The term ED is often used interchangeably with Emergence Agitation (EA) and Postanesthetic Excitement (PE). It is maybe related to age, volatile anesthetics, perioperative anxiety and pain. ED in children under 2 years of age can be accurately diagnosed with the PAED scale, but the scale also has its limitations. ED is prevented mainly from the preoperative anxiety, postoperative analgesia and intraoperative propofol, dexemedetomidine. Propofol, dexmedetomi- dine and magnesium sulfate could be applied in recovery room. This paper summarizes the latest progress of ED and provides a good ba- sis to diagnosis, treatment, prevention.