摘要目的 评价多种方法联合预防学龄前儿童全身麻醉恢复期躁动的效果.方法 择期单眼斜视矫正术患儿450例,性别不限,年龄3～6岁,体重16～25 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为3组(n=150):常规预防组(Ⅰ组)、咪达唑仑-常规预防组(Ⅱ组)和卡通视频辅助入室-PACU期间家属陪伴-常规预防组(Ⅲ组).Ⅰ组喉罩置入后经10 min静脉输注右美托咪定0.3μg∕kg;在Ⅰ组基础上,Ⅱ组等候区静脉输注咪达唑仑0.05 mg∕kg,Ⅲ组家属陪伴观看访视时由患儿选定的卡通动画片入室,PACU期间由家属陪伴.记录入室时焦虑评分、麻醉诱导期合作度量表评分、恢复期躁动发生情况和程度、苏醒时间和PACU停留时间.结果 与Ⅰ组比较,Ⅱ组和Ⅲ组入室时焦虑评分和麻醉诱导期合作度量表评分降低,恢复期躁动发生率(Ⅰ组25.3％,Ⅱ组12.0％,Ⅲ组3.3％)降低,Ⅱ组苏醒时间和PACU停留时间延长(P<0.05);与Ⅱ组比较,Ⅲ组恢复期躁动发生率降低(P<0.05).3组恢复期躁动程度构成比差异无统计学意义(P>0.05).结论 卡通视频辅助入室-PACU期间家属陪伴-常规预防联合法可有效地预防学龄前儿童全身麻醉恢复期躁动的发生.

abstractsObjective To evaluate the efficacy of combination of multiple measures in preventing agitation during recovery from general anesthesia in the preschool children. Methods Four hundred and fifty preschool pediatric patients of both sexes, aged 3-6 yr, weighing 16-25 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective monocular strabismus surgery, were di-vided into 3 groups ( n=150 each) using a random number table method: routine prevention group ( groupⅠ) , midazolam-routine prevention group ( groupⅡ) and cartoon video-assisted admission to operating room-family members accompanying in postanesthesia care unit ( PACU)-routine prevention group ( groupⅢ) . Dexmedetomidine 0. 3μg∕kg was intravenously infused over 10 min in groupⅠ. On the basis of groupⅠ, midazolam 0. 05 mg∕kg was intravenously infused in the holding area in group Ⅱ, and children were admitted to the operating room while they were watching cartoons selected by themselves when accompanied by family members, and they were also accompanied by family members in PACU in group Ⅲ. The modi-fied Yale Preoperative Anxiety Scale score on admission to the operating room, Induction Compliance Checklist score, occurrence and degree of agitation during the recovery period, emergence time and dura-tion of PACU stay were recorded. Results Compared with groupⅠ, the modified Yale Preoperative Anxi-ety Scale score on admission to the operating room and Induction Compliance Checklist score were signifi-cantly decreased, and the incidence of agitation during the recovery period ( 25. 3％ in group Ⅰ, 12. 0％in group Ⅱ, 3. 3％ in group Ⅲ) was decreased in Ⅱ and Ⅲ groups , and the emergence time and dura-tion of PACU stay were significantly prolonged in groupⅡ( P<0. 05) . The incidence of agitation during the recovery period was significantly lower in group Ⅲ than in groupⅡ (P<0. 05). There was no significant difference in the constituent ratio of the degree of agitation among the three groups ( P>0. 05) . Conclusion Cartoon video-assisted admission to operating room-family members accompanying in PACU-routine pre-vention can effectively prevent the occurrence of agitation during recovery from general anesthesia in the pre-school children.