目的:扁桃体周围脓肿(PTA)是一种常见的儿科感染,需要引流。意识镇静(CS)可以促进不合作儿童的引流。然而,它有风险,尤其是当气道受损时.此外,关于其安全性和有效性的证据有限.这项研究检查了安全性,减轻疼痛,在CS下接受PTA治疗的住院儿科患者的焦虑管理。
方法:我们对118名2-15岁儿童进行了前瞻性观察性病例系列,其中155次PTA发作,从2016年到2023年管理。42次使用意识镇静。比较CS和非CS(仅局部麻醉)的结果。并发症评估安全性。通过脓液的量来评估疗效,住院参数,疼痛评分,和复发。
结果:在CS组中,除了年龄较小(9岁vs11岁,p=0.001),在人口统计学和表现参数方面没有发现显著差异。CS发生了一次轻微的氧饱和度降低(2%)事件。有CS的脓肿引流量大于无CS的脓肿引流量,4.9±4mLvs.3.2±2mL,分别(p=0.03)。各组的住院时间相似。CS的最大疼痛评分低于非CS,1.4±2vs4.2±3(p<0.001);同样,静脉注射止痛药的使用频率较低,0.9±1vs.1.6±3(p=0.045),和需要重新抽吸是不太常见的14%与28%(p=0.04),CS比非CS,分别。CS的三个月复发率在数字上较低(5%vs.14%非CS)。
结论:清醒镇静有助于PTA引流,与局部麻醉相比,在儿童中具有优异的安全性和提高的疗效。在引流和住院期间疼痛评分均降低。我们的前瞻性数据增加了有限的证据,支持CS作为不合作的儿科患者脓肿引流的可行选择。进一步的研究是必要的,以确认潜在的长期减少复发。
OBJECTIVE: Peritonsillar abscess (PTA) is a common pediatric infection requiring drainage. Conscious Sedation (CS) can facilitate drainage in uncooperative children. However, it carries risks, especially if the airway is compromised. Moreover, evidence on its safety and efficacy is limited. This study examined the safety, pain reduction, and anxiety management of hospitalized pediatric patients treated for PTA under CS.
METHODS: We performed a prospective observational
case series of 118 children aged 2-15 years with 155 PTA episodes, managed from 2016 to 2023. Conscious sedation was used in 42 episodes. Outcomes were compared among CS and non-CS (local anesthesia only). Complications assessed safety. Efficacy was evaluated by the amount of pus, hospitalization parameters, pain scores, and recurrence.
RESULTS: No significant differences were found regarding the demographic and presentation parameters except for younger age among the CS group (9 vs 11 years p = 0.001). One minor oxygen desaturation (2 %) event occurred with CS. Abscess drainage amount was greater with CS than non-CS, 4.9±4 mL vs. 3.2±2 mL, respectively (p = 0.03). Hospitalization stays were similar among groups. Maximum pain scores were lower with CS than non-CS, 1.4 ± 2 vs 4.2 ± 3 (p < 0.001); similarly, IV pain medication was used less frequently, 0.9 ± 1 vs. 1.6 ± 3 (p = 0.045), and the need for re-aspiration was less common 14 % vs. 28 % (p = 0.04), with CS than non-CS, respectively. The three-month recurrence rate was numerically lower with CS (5 % vs. 14 % non-CS).
CONCLUSIONS: Conscious sedation facilitates PTA drainage with excellent safety and improved efficacy compared to local anesthesia in children. Pain scores are reduced both during drainage and hospitalization. Our prospective data add to the limited evidence supporting CS as a viable option for abscess drainage in uncooperative pediatric patients. Further study is warranted to confirm potential long-term reductions in recurrence.