A comparison of emergence delirium scales following general anesthesia in children
A comparison of emergence delirium scales following general anesthesia in children
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DOI：
10.1111/j.1460-9592.2010.03328.x
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发表时间：
2010-08-01
影响因子：
1.7
通讯作者：
Cyna, Allan M.
中科院分区：
文献类型：
--
作者：
Bajwa, Samira A.;Costi, David;Cyna, Allan M.
背景：自从七氟醚等短效挥发物被引入以来，突发性妄想(Ed)越来越引起人们的关注。方法：我们比较了儿科麻醉突发性妄想(PAED)、Watcha和Cravero量表在118名全麻恢复18年的117名儿童中的存在情况。主要的衡量标准是在每个量表上评估的ED的最差得分，以及每个患者在PACU期间的得分。一位经验丰富的麻醉师观察员也对ED的存在进行了主观评估。结果：PAED评分=10的儿童中检出ED 37例(32%)，Watcha检出30例(26%)，Cravero 41例(35%)。25名患者(21%)在所有三个量表上都达到了ED的标准，所有8名患者都是由经验丰富的儿科麻醉师观察员评估的。被评估为有或没有ED的患者的PAED评分的中位数(四分位数范围)分别为Watcha，12(11，14)，7(4，8)；Cravero，11(9，13)，7(4，8)；以及有经验的麻醉师观察者，14.5(13.5，16.5)，7(6，10)。结论：这三个量表相互之间有较好的相关性，但在评估是否存在ED方面存在个体限制。在没有开发一种改进的研究工具来评估ED的情况下，PAED评分12似乎比PAED评分=10提供了更高的敏感性和特异性。然而，Watcha量表在临床实践中是一种更简单的工具，而且可能比其他量表具有更高的总体敏感性和特异性。
P>Background:Emergence delirium (ED) is of increasing interest since the introduction of short-acting volatiles such as sevoflurane.Methods:We compared the Pediatric Anesthesia Emergence Delirium (PAED), Watcha and Cravero scales for assessing the presence of ED in 117 of 118 consecutive children < 18 years recovering from general anesthesia. The primary measure was the worst score for ED as assessed on each scale and for each patient during their PACU stay. An experienced anesthetist observer also made a subjective assessment of the presence of ED.Results:A PAED score of >= 10 detected ED in 37 children (32%), while the Watcha detected 30 (26%) and Cravero 41 (35%). Twenty-five patients (21%) fulfilled criteria for ED in all three scales as did all eight patients assessed by the experienced pediatric anesthetist observer. Median PAED scores (interquartile ranges) for patients assessed as having ED or not respectively were for Watcha, 12 (11,14), 7 (4,8); for Cravero, 11 (9,13), 7 (4,8); and for the experienced anesthetist observer, 14.5 (13.5,16.5), 7 (6,10).Conclusions:All three scales correlated reasonably well with each other but have individual limitations in their potential to assess whether ED is present. In the absence of developing an improved research tool to assess ED, a PAED score > 12 appears to provide greater sensitivity and specificity than a PAED score >= 10. However, the Watcha scale is a simpler tool to use in clinical practice and may have a higher overall sensitivity and specificity than the other scales.