背景:非手术室麻醉是一个不断发展的医学领域,可能会增加并发症的风险,特别是在低收入和中等收入国家。
目的:本研究的目的是描述小儿非手术室麻醉后并发症的发生率并探讨其危险因素。
方法:在这项前瞻性观察研究中,我们纳入了所有在低收入和中等收入国家的大学医院放射科接受镇静或麻醉的5岁以下儿童.患者分为两组:有并发症组和无并发症组。然后,我们比较了两组,采用单变量和多变量logistic回归模型探讨并发症的主要危险因素。
结果:我们包括256名儿童,并发症发生率为8.6%。非手术室麻醉相关发病率的主要预测因素是:危重病儿童(aOR=2.490;95%CI:1.55-11.21)。预测困难气道(aOR=5.704;95%CI:1.017-31.98),和组织不足(aOR=52.6;95%CI:4.55-613)。在NORA前几天进行麻醉前咨询可防止并发症(aOR=0.263;95CI:0.080-0.867)。
结论:在我们的放射学环境中,儿童在NORA期间并发症的发生率仍然很高。调查发病率的预测因素允许高风险患者选择,允许采取预防措施。采取了一些改进措施来解决组织的不足。
BACKGROUND: Nonoperating room anesthesia is a growing field of medicine that can have an increased risk of complications, particularly in low- and middle-income countries.
OBJECTIVE: The aim of this
study was to describe the incidence of complications after pediatric nonoperating room anesthesia and investigate its risk factors.
METHODS: In this prospective observational
study, we included all children aged less than 5 years who were sedated or anesthetized in the radiology setting of a university hospital in a low- and middle-income country. Patients were divided into two groups: complications or no-complications groups. Then, we compared both groups, and univariable and multivariable logistic regression models were used to investigate the main risk factors for complications.
RESULTS: We included 256 children, and the incidence of complications was 8.6%. The main predictors of nonoperating room anesthesia-related morbidity were: critically-ill children (aOR = 2.490; 95% CI: 1.55-11.21), predicted difficult airway (aOR = 5.704; 95% CI: 1.017-31.98), and organization insufficiencies (aOR = 52.6; 95% CI:4.55-613). The preanesthetic consultation few days before NORA protected against complications (aOR = 0.263; 95%CI: 0.080-0.867).
CONCLUSIONS: The incidence of complications during NORA among children in our radiology setting remains high. Investigating predictors for morbidity allowed high-risk patient selection, which allowed taking precautions. Several improvement measures were taken to address the organization\'s insufficiencies.