Greater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys
Greater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys
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DOI：
10.1097/00000542-199712000-00006
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发表时间：
1997-12-01
期刊：
影响因子：
8.8
通讯作者：
Manabe, M
中科院分区：
文献类型：
--
作者：
Aono, J;Ueda, W;Manabe, M
背景资料：根据作者的临床经验，学龄前儿童在七氟烷给药后比年龄较大的儿童更容易出现谵妄。63名3-5岁学龄前男孩（美国麻醉医师协会[阿萨]身体状况I级）和53名6-10岁的学龄男孩（阿萨身体状态I）接受小泌尿外科手术的患者随机分配接受氟烷或七氟烷，因此分为4组：学龄前氟烷（n=32）、学龄前七氟烷（n=31）、学龄前氟烷（n=27）和学龄前七氟烷（n=26）。通过吸入氟烷或七氟烷的氧气溶液诱导麻醉，并在整个手术过程中维持每种药物的最低肺泡浓度。术中和术后镇痛，骶管阻滞0.5-1.0 ml/kg 0.25%普通布比卡因和局部浸润3-5 ml 1%利多卡因为所有患者提供。恢复特点和谵妄的发病率在四groups.Results之间进行了比较：两名患者在学龄前氟烷组，一名在学龄前七氟烷组，和一名在学校氟烷组被排除在比较，因为不充分的镇痛或搅拌前诱导。在两个年龄组中，七氟烷的苏醒时间明显快于氟烷（约3分钟）。学龄前七氟烷组恢复期谵妄的发生率（40%）显著高于其他组（学龄前氟烷，10%;学校氟烷，15.4%;学校七氟烷，11.5%）。结论：与氟烷相比，七氟烷提供更快的苏醒和早期恢复，但学龄前男孩七氟烷后谵妄的发生率更高。
Background: In the authors' clinical experience, preschool children are more likely to show delirium after sevoflurane than are older children.Methods: Sixty-three preschool boys aged 3-5 yr (classified as American Society of Anesthesiologists [ASA] physical status I), and 53 school-age boys aged 6-10 yr (ASA physical status I) who underwent minor urologic surgery were randomly assigned to receive either halothane or sevoflurane, thus creating four groups: preschool-halothane (n=32), preschool-sevoflurane (n=31), school-halothane (n=27), and school-sevoflurane (n=26). Anesthesia was induced by inhalation of halothane or sevoflurane in oxygen and was maintained at 1 minimum alveolar concentration of each agent throughout surgery. For intra- and postoperative analgesia, caudal block with 0.5-1.0 ml/kg 0.25% plain bupivacaine and topical infiltration with 3-5 ml 1% lidocaine were provided for all patients. Recovery characteristics and incidence of delirium on emergence were compared among the four groups.Results: Two patients in the preschool-halothane group, one in the preschool-sevoflurane group, and one in the school-halothane group were excluded from the comparison because of insufficient analgesia or agitation before induction. In both age groups, the time to emergence from sevoflurane was significantly faster (about 3 min) than from halothane. The incidence of delirium during recovery in the preschool-sevoflurane group (40%) was significantly greater than that in the other groups (preschool-halothane, 10%; school-halothane, 15.4%; school-sevoflurane, 11.5%).Conclusions: Sevoflurane provided quicker emergence and early recovery compared with halothane, but the incidence of delirium was greater in preschool boys after sevoflurane.