PDF(Pubmed)
Abstract：
Some studies reported that pediatric patients undergoing otorhinolaryngology (ENT) and ophthalmic surgeries have higher incidences of emergence agitation (EA). Children with EA tend to carry the risk of self-harm, have longer periods of recovery and delayed hospital discharge. Consequently, EA needs to be monitored and risk factors ought to be emphasized to implement preventative measures. The objective of this study was to describe EA and to identify risk factors after pediatric ophthalmic or ENT surgery.
Between September 2021 and December 2021, a cross-sectional study was conducted in 100 children aged of 0-12 years who underwent ophthalmic or ENT surgery. The Watcha scale was used to observe and record EA, which was defined at levels of 3 or 4 at any time in the post-anesthesia care unit (PACU). The pain intensity was graded with the Face, Legs, Activity, Cry, Consolability (FLACC) Scale after surgery. Patient and surgery-related characteristics, the behavioral criteria of EA, the pharmacologic and non-pharmacologic interventions and recovery outcomes were objectively recorded. A binary logistic regression model was constructed to identify the associated factors of EA.
From the 100 analyzed children, 58 were males and 42 were females, and 44 patients received ophthalmic surgery and 56 ENT surgery. The median age was 6 (IQR 4-7) years. The overall incidence of EA among pediatrics was 30% (34.5% for ENT and 24.4% for ophthalmic surgery). High preoperative modified Yale Preoperative Anxiety scale (m-YPAS) grade (OR = 1.19, 95%CI 1.06-1.33, P = 0.003) and high postoperative FLACC score (OR = 3.36, 95%CI 1.88-6.02, P < 0.001) were risk factors for EA.
This study identified that preoperative anxiety and postoperative pain are associated with EA in children after ophthalmic or ENT surgery. Preoperative anxiety assessment and management, and administration of adjunct analgesic treatments should be considered in the routine care.
Between September 2021 and December 2021, a cross-sectional study was conducted in 100 children aged of 0-12 years who underwent ophthalmic or ENT surgery. The Watcha scale was used to observe and record EA, which was defined at levels of 3 or 4 at any time in the post-anesthesia care unit (PACU). The pain intensity was graded with the Face, Legs, Activity, Cry, Consolability (FLACC) Scale after surgery. Patient and surgery-related characteristics, the behavioral criteria of EA, the pharmacologic and non-pharmacologic interventions and recovery outcomes were objectively recorded. A binary logistic regression model was constructed to identify the associated factors of EA.
From the 100 analyzed children, 58 were males and 42 were females, and 44 patients received ophthalmic surgery and 56 ENT surgery. The median age was 6 (IQR 4-7) years. The overall incidence of EA among pediatrics was 30% (34.5% for ENT and 24.4% for ophthalmic surgery). High preoperative modified Yale Preoperative Anxiety scale (m-YPAS) grade (OR = 1.19, 95%CI 1.06-1.33, P = 0.003) and high postoperative FLACC score (OR = 3.36, 95%CI 1.88-6.02, P < 0.001) were risk factors for EA.
This study identified that preoperative anxiety and postoperative pain are associated with EA in children after ophthalmic or ENT surgery. Preoperative anxiety assessment and management, and administration of adjunct analgesic treatments should be considered in the routine care.
摘要：
背景：一些研究报道，接受耳鼻咽喉科（ENT）和眼科手术的儿科患者出现躁动（EA）的发生率较高。患有EA的孩子往往有自我伤害的风险，有更长的恢复期和延迟出院。因此,需要对EA进行监控，并应强调风险因素以实施预防措施。这项研究的目的是描述EA并确定儿科眼科或ENT手术后的危险因素。
方法：在2021年9月至2021年12月之间，对100名0-12岁接受眼科或耳鼻喉科手术的儿童进行了横断面研究。使用Watcha量表观察和记录EA，在麻醉后监护病房（PACU）的任何时候都定义为3或4级。疼痛强度与面部分级，腿,活动,哭吧,手术后的协作性(FLACC)量表。患者和手术相关特征，EA的行为标准，客观记录药物和非药物干预措施以及康复结局.建立二元logistic回归模型以确定EA的相关因素。
结果：从分析的100名儿童中，58人是男性，42人是女性，44例患者接受眼科手术和56例ENT手术。中位年龄为6(IQR4-7)岁。儿科学中EA的总发生率为30％（ENT为34.5％，眼科手术为24.4％）。术前改良Yale术前焦虑量表(m-YPAS)评分高(OR=1.19,95CI1.06~1.33,P=0.003)和术后FLACC评分高(OR=3.36,95CI1.88~6.02,P<0.001)是EA的危险因素。
结论：这项研究发现，在眼科或耳鼻喉手术后的儿童中，术前焦虑和术后疼痛与EA相关。术前焦虑评估和管理，在常规护理中应考虑辅助镇痛治疗。
方法：在2021年9月至2021年12月之间，对100名0-12岁接受眼科或耳鼻喉科手术的儿童进行了横断面研究。使用Watcha量表观察和记录EA，在麻醉后监护病房（PACU）的任何时候都定义为3或4级。疼痛强度与面部分级，腿,活动,哭吧,手术后的协作性(FLACC)量表。患者和手术相关特征，EA的行为标准，客观记录药物和非药物干预措施以及康复结局.建立二元logistic回归模型以确定EA的相关因素。
结果：从分析的100名儿童中，58人是男性，42人是女性，44例患者接受眼科手术和56例ENT手术。中位年龄为6(IQR4-7)岁。儿科学中EA的总发生率为30％（ENT为34.5％，眼科手术为24.4％）。术前改良Yale术前焦虑量表(m-YPAS)评分高(OR=1.19,95CI1.06~1.33,P=0.003)和术后FLACC评分高(OR=3.36,95CI1.88~6.02,P<0.001)是EA的危险因素。
结论：这项研究发现，在眼科或耳鼻喉手术后的儿童中，术前焦虑和术后疼痛与EA相关。术前焦虑评估和管理，在常规护理中应考虑辅助镇痛治疗。
