围术期小儿应激反应因素与调控

Anesthesia and perioperative stress response in children

目的 小儿围术期应激反应的典型表现是神经内分泌系统、免疫系统和代谢系统的变化.术前焦虑、紧张等心理因素以及麻醉、手术创伤均可影响小儿围术期应激反应,而且应激反应的剧烈程度与围术期并发症的发生率密切相关.目的 通过综述比较,确定更能有效降低小儿围术期应激反应的麻醉药物、麻醉方法和术后镇痛方式.内容 综述小儿围术期应激反应的生物学特点以及小儿围术期心理状况、常用麻醉药物、麻醉方法对围术期应激反应的影响.趋向 深入研究比较不同术后镇痛方式对小儿术后应激反应的影响,以降低小儿术后相关并发症.

Background Perioperaive stress response in children can be caused by psychological factors such as stress and anxiety, and anesthesia and surgical procedures. It is characterized by neurohumoral, immunologic and metabolic alterations. The intensity of stress response is closely correlated to the incidence of perioperative complications. Purpose To determine more effectively anesthetic techniques, anesthetics and postoperative analgesia in reducing pediatric perioperative stress response.Content This review outlines the biological characteristics of perioperaive stress response, and the effects of psychological state,commonly used anesthetic techniques and anesthetics on perioperaive stress response in children. Trend Further investigations on the effects of different postoperative analgesia on postoperative stress response are needed to reduce the risk of postoperative complications in children.