PDF(Pubmed)
Abstract：
UNASSIGNED: Emergence agitation (EA) is one of the most common complications in clinical general anesthesia during recovery in adults. Remifentanil and propofol can reduce the incidence of EA, but with no randomized controlled trial to evaluate their effectiveness for treating EA. This study aims to compare the effectiveness of remifentanil and propofol for treating EA following general anesthesia.
UNASSIGNED: Among 152 randomized patients with a mean of 49.5 years, and 99 (65.1%) of them being male, 149 were divided into two groups for subsequent analysis. The remifentanil group (Group R, n = 74) received a 0.5μg kg-1 remifentanil infusion followed by a 0.05μg kg-1 min-1 infusion until 15 minutes, after the onset of agitation. The propofol group (Group P, n = 75) received a 1mg kg-1 propofol infusion once agitation occurred. Emergence agitation was assessed using the Riker Sedation Agitation Score, with a score of ≥5 defining emergence agitation. During the post-anesthesia care unit (PACU), the recurrence of emergence agitation, time to extubation, and discharge from PACU were evaluated.
UNASSIGNED: The incidence of reoccurring emergence agitation was lower in Group R (29.7%) compared with Group P (49.3%), with an odds ratio of 0.44 (95% CI 0.22-0.85; P=0.014). The time to extubation was shorter in Group R (mean 12min, range 8-15 min) compared with Group P (mean 17min, range 13-21 min) (P<0.001), as was the time discharge from the PACU (mean 30.5 min, range 25-40 min) vs Group P (mean 37.5 min, range 31-50 min) (P=0.001).
UNASSIGNED: Treatment of emergence agitation in adults with remifentanil infusion is more effective than propofol, with a shorter time to extubation and discharge from PACU.
UNASSIGNED: Among 152 randomized patients with a mean of 49.5 years, and 99 (65.1%) of them being male, 149 were divided into two groups for subsequent analysis. The remifentanil group (Group R, n = 74) received a 0.5μg kg-1 remifentanil infusion followed by a 0.05μg kg-1 min-1 infusion until 15 minutes, after the onset of agitation. The propofol group (Group P, n = 75) received a 1mg kg-1 propofol infusion once agitation occurred. Emergence agitation was assessed using the Riker Sedation Agitation Score, with a score of ≥5 defining emergence agitation. During the post-anesthesia care unit (PACU), the recurrence of emergence agitation, time to extubation, and discharge from PACU were evaluated.
UNASSIGNED: The incidence of reoccurring emergence agitation was lower in Group R (29.7%) compared with Group P (49.3%), with an odds ratio of 0.44 (95% CI 0.22-0.85; P=0.014). The time to extubation was shorter in Group R (mean 12min, range 8-15 min) compared with Group P (mean 17min, range 13-21 min) (P<0.001), as was the time discharge from the PACU (mean 30.5 min, range 25-40 min) vs Group P (mean 37.5 min, range 31-50 min) (P=0.001).
UNASSIGNED: Treatment of emergence agitation in adults with remifentanil infusion is more effective than propofol, with a shorter time to extubation and discharge from PACU.
摘要：
■急性躁动（EA）是成人康复期间临床全身麻醉中最常见的并发症之一。瑞芬太尼和丙泊酚可以降低EA的发生率，但没有随机对照试验来评估其治疗EA的有效性。本研究旨在比较瑞芬太尼和丙泊酚治疗全身麻醉后EA的有效性。
■在平均49.5年的152名随机患者中，其中99人(65.1%)是男性，149人分为两组进行后续分析。瑞芬太尼组(R组,n=74）接受0.5μgkg-1瑞芬太尼输注，然后进行0.05μgkg-1min-1输注，直至15分钟，在激动开始后。丙泊酚组（P组，n=75）一旦发生躁动，就接受1mgkg-1异丙酚输注。使用Riker镇静激动评分评估出现的躁动，评分≥5，定义出现躁动。在麻醉后监护病房（PACU）期间，出现躁动的复发，拔管时间，并对PACU的出院情况进行了评估。
■与P组（49.3％）相比，R组（29.7％）的复发躁动发生率较低，比值比为0.44（95%CI0.22-0.85；P=0.014）。R组拔管时间较短(平均12min，范围8-15分钟)与P组(平均17分钟，范围13-21分钟)(P<0.001)，从PACU排出的时间(平均30.5分钟，范围25-40分钟）与P组（平均37.5分钟，范围31-50分钟）（P=0.001）。
■瑞芬太尼输注治疗成人苏醒期躁动比丙泊酚更有效，从PACU拔管和排出的时间较短。
■在平均49.5年的152名随机患者中，其中99人(65.1%)是男性，149人分为两组进行后续分析。瑞芬太尼组(R组,n=74）接受0.5μgkg-1瑞芬太尼输注，然后进行0.05μgkg-1min-1输注，直至15分钟，在激动开始后。丙泊酚组（P组，n=75）一旦发生躁动，就接受1mgkg-1异丙酚输注。使用Riker镇静激动评分评估出现的躁动，评分≥5，定义出现躁动。在麻醉后监护病房（PACU）期间，出现躁动的复发，拔管时间，并对PACU的出院情况进行了评估。
■与P组（49.3％）相比，R组（29.7％）的复发躁动发生率较低，比值比为0.44（95%CI0.22-0.85；P=0.014）。R组拔管时间较短(平均12min，范围8-15分钟)与P组(平均17分钟，范围13-21分钟)(P<0.001)，从PACU排出的时间(平均30.5分钟，范围25-40分钟）与P组（平均37.5分钟，范围31-50分钟）（P=0.001）。
■瑞芬太尼输注治疗成人苏醒期躁动比丙泊酚更有效，从PACU拔管和排出的时间较短。
