Visual preconditioning reduces emergence delirium in children undergoing ophthalmic surgery: a randomised controlled trial
Visual preconditioning reduces emergence delirium in children undergoing ophthalmic surgery: a randomised controlled trial
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视觉预处理可减少接受眼科手术的儿童的苏醒性谵妄：一项随机对照试验。
DOI：
10.1016/j.bja.2018.03.033
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发表时间：
2018-08-01
影响因子：
9.8
通讯作者：
Liu, Y. Z.
中科院分区：
文献类型：
--
作者：
Lin, Y.;Shen, W.;Liu, Y. Z.
背景：突发性谵妄是儿童常见的并发症，尤其是在接受眼科手术的学龄前儿童。本研究的目的是探讨视觉预处理（手术前一天在待手术眼上敷眼罩>= 3 h）对七氟醚麻醉下眼科手术后出现谵妄的影响。方法：179名接受单侧白内障手术的儿童，年龄3-7岁，参与了这项前瞻性、盲法、随机研究。受试者随机分为两组，一组接受视觉预处理（P组，n = 89），另一组在手术前接受程序化解释（C组，n = 90）。主要结局是通过儿科麻醉出现性谵妄（PAED）量表评估出现性谵妄的发生率。次要结局包括急诊时间和麻醉后护理单位（PACU）停留时间。结果：P组患儿突发性谵妄发生率明显低于C组[16.9% vs 44.4%，优势比（OR） 4.0, 95%可信区间（CI） 2.0 ~ 8.0]。P组最大PAED评分低于C组[4 (0-20)vs 9(0-20)，中位差-3.0,95% CI -5.0 ~ -1.0]。视觉预处理延长应急时间(P
Background: Emergence delirium is a common complication in children, especially in preschool children undergoing ophthalmic surgery. The aim of the study was to investigate the effects of visual preconditioning (application of an eyepatch over the eye to be operated for >= 3 h the day before surgery) on emergence delirium after ophthalmic surgery under sevoflurane anaesthesia.Methods: One hundred and seventy-nine children undergoing unilateral cataract surgery, aged 3-7 yr, were involved in this prospective, blinded, randomised study. Subjects were randomised to receive visual preconditioning (Group P, n = 89) or to receive programmed explanation the day before surgery (Group C, n = 90). The primary outcome was incidence of emergence delirium evaluated by the paediatric anaesthesia emergence delirium (PAED) scale. The secondary outcomes included emergence time and post-anaesthesia care unit (PACU) stay time.Results: Children in Group P had a significantly lower incidence of emergence delirium than those in Group C [16.9% vs 44.4%, odds ratio (OR) 4.0, 95% confidence interval (CI) 2.0 to 8.0]. The maximal PAED score was lower in Group P than in Group C [4 (0-20) vs 9 (0-20), median difference -3.0, 95% CI -5.0 to -1.0]. Visual preconditioning prolonged emergence time (P