Emergence agitation: current knowledge and unresolved questions.
Emergence agitation: current knowledge and unresolved questions.
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DOI：
10.4097/kja.20097
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发表时间：
2020-12
影响因子：
2.9
通讯作者：
Sung TY
中科院分区：
文献类型：
--
作者：
Lee SJ;Sung TY
突发性躁动(EA)，也被称为突发性精神错乱，可以有临床上重要的后果。电针的作用机制尚不清楚。提出的EA危险因素包括年龄、男性、手术类型、急诊手术、使用低血气分配系数的吸入麻醉药、手术持续时间长、抗胆碱能药、术前用苯二氮卓类药物、排尿紧迫感、术后疼痛和有无侵入性装置。如果术前或术中的客观监测能够预测急性期躁动的发生，这将有助于减少其不良后果。有几个工具可用于评估EA。然而，没有标准化的临床研究实践指南，其发生率随评估工具或所用定义的不同而有很大差异。全凭静脉麻醉、异丙酚、μ类阿片受体激动剂、N-甲基-D-天冬氨酸受体拮抗剂、奈福潘、α-2受体激动剂、区域镇痛、多模式镇痛、家长在场诱导和术前教育有助于预防EA。然而，很难识别高危患者并在不同的临床情况下应用预防措施。预防策略的风险因素和结果因研究方法和患者评估的不同而不同。本文综述了电针研究的重要成果和未来研究的方向。
Emergence agitation (EA), also referred to as emergence delirium, can have clinically significant consequences. The mechanism of EA remains unclear. The proposed risk factors of EA include age, male sex, type of surgery, emergency operation, use of inhalational anesthetics with low blood–gas partition coefficients, long duration of surgery, anticholinergics, premedication with benzodiazepines, voiding urgency, postoperative pain, and the presence of invasive devices. If preoperative or intraoperative objective monitoring could predict the occurrence of agitation during emergence, this would help to reduce its adverse consequences. Several tools are available for assessing EA. However, there are no standardized clinical research practice guidelines and its incidence varies considerably with the assessment tool or definition used. Total intravenous anesthesia, propofol, μ-opioid agonists, N-methyl-D-aspartate receptor antagonists, nefopam, α2-adrenoreceptor agonists, regional analgesia, multimodal analgesia, parent-present induction, and preoperative education for surgery may help in preventing of EA. However, it is difficult to identify patients at high risk and apply preventive measures in various clinical situations.The risk factors and outcomes of preventive strategies vary with the methodologies of studies and patients assessed.This review discusses important outcomes of research on EA and directions for future research.
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