5 kg以下婴儿全麻苏醒延迟影响因素的分析

An Analysis of Delay Recovery Causes after General Anesthesia in Infants under 5 kg

探讨5 kg以下小婴儿全麻苏醒的质量以及该人群发生苏醒延迟常见的影响因素.选择昆明市儿童医院5年间行全麻插管的择期手术,体重小于等于5 kg的婴儿.筛选条件为非心脏及颅内手术,术前无转入ICU的计划,手术时间2 h以内.得到病例共1 061例,其中苏醒延迟组为379例,对照组为无苏醒延迟的余下病例共682例.对两组患儿的一般资料,术中是否发生低体温、低血糖,是否大量输液(血),是否使用肌松剂,是否复合神经阻滞或椎管内麻醉进行回顾性对照分析.苏醒延迟组与未发生苏醒延迟组相比较,患儿的体重较低,矫正胎龄较小,发生低血糖、低体温以及术中大量输液(血)的比例较高. 5 kg以下小婴儿全麻插管后苏醒延迟发生率较高,低体重、低矫正胎龄、低体温、低血糖、低矫正胎龄在苏醒延迟中均有相对较高的发生率.

This paper expl0res the delay recovery incidence rate and causes after general anesthesia in infants less than 5 kg. Totally 1 061 infants whose weight were under 5 kg undergoing schedule general anesthesia were selected and divided into two groups—delay recovery group（ 379 cases） and normal group（ 682 cases）. All the cases except cardiac surgery and neurosurgery didn＇t plan into ICU before surgery. Both groups were retrospective and control studied the patient sex,correction of fetal age,weight,surgery time,hypothermia,hypoglycemia,muscle relaxants,massive transfusion and intraspinal anesthesia or nerve block. There were no significantly differences in sex,operation time and muscle relaxants or not. But the delay recovery group＇s incidence rate of the low correction of fetal age,low weight,hypothermia,hypoglycemia,massive transfusion were higher than the other; and the delay recovery group＇s intraspinal anesthesia or nerve block rate was lower than the other. There was statistically significant difference. The delay recovery incidence rate was higher after general anesthesia in infants under 5 kg. The low correction of fetal age,low weight,hypothermia,hypoglycemia,massive transfusion and none intraspinal anesthesia or none nerve block were usually causes.