全身麻醉手术患儿焦虑水平与麻醉诱导合作度的相关性分析

Correlation Analysis between Anxiety Level and Anesthesia Induction Cooperation Degree in Children Undergoing General Anesthesia Surgery

目的:探讨全身麻醉手术患儿焦虑水平与麻醉诱导合作度的相关性。方法:回顾性分析2018年12月-2020年12月本院收治的61例全身麻醉手术患儿的临床资料,依照患儿麻醉诱导期合作量表(ICC)评分进行分组,ICC评分7~10分为不配合组(n=17),3~6分为中度配合组(n=31),0~2分为高度配合组(n=13)。比较三组术前访视时、术前等待时、麻醉诱导时的m-YPAS评分;并分析全身麻醉患儿焦虑水平与麻醉诱导合作度的相关性;比较三组患儿术中情况与血流动力学指标。结果:术前访视时、术前等待时和麻醉诱导时,三组m-YPAS评分比较,差异均有统计学意义(P<0.05)。术前访视时、术前等待时和麻醉诱导时,不配合组m-YPAS评分均高于中度配合组和高度配合组,且中度配合组高于高度配合组,差异均有统计学意义(P<0.05)。随着麻醉时间的接近三组患儿m-YPAS评分升高(P<0.05)。患儿在术前访视时、术前等待时以及麻醉诱导时的焦虑水平与麻醉诱导合作度呈负相关(P<0.05)。三组术中出血量、瑞芬太尼用量、丙泊酚用量、麻醉时间和手术时间比较,差异均无统计学意义(P>0.05)。麻醉前,三组DBP、SBP和HR比较,差异均无统计学意义(P>0.05)。麻醉后,三组DBP、SBP比较,差异均有统计学意义(P<0.05)。麻醉后,不配合组DBP、SBP均高于中度配合组和高度配合组,差异均有统计学意义(P<0.05)。术后30 min,三组患儿DBP比较,差异有统计学意义(P<0.05)。术后30 min,不配合组DBP高于中度配合组和高度配合组,差异均有统计学意义(P<0.05)。术后30 min,不配合组HR高于中度配合组和高度配合组,差异均有统计学意义(P<0.05)。结论:全身麻醉手术患儿术前不同时间的焦虑水平与麻醉诱导合作度呈负相关,麻醉诱导合作度差虽然不会影响手术情况,但会影响对患儿血流动力学,因此需要采取科学合理的措施,来降低全身麻醉手术患儿的焦虑水平,提升麻醉诱导合作度。

Objective:To explore the correlation between anxiety level and anesthesia induction cooperation degree in children undergoing general anesthesia surgery.Method:The clinical data of 61 children underwent general anesthesia surgery in our hospital from December 2018 to December 2020 were retrospective analysed.The children were divided into three groups according to ICC score of anesthesia induction period.ICC score of 7-10 was divided into non coordination group(n=17),ICC score of 3-6 was divided into moderate coordination group(n=31),ICC score of 0-2 were divided into high coordination group(n=13).The m-YPAS scores of preoperative visit,preoperative waiting and anesthesia induction were compared among three groups;the correlation between anxiety level and anesthesia induction cooperation degree was analyzed;the intraoperative conditions and hemodynamic indexes were compared among three groups.Result:There were significant differences in m-YPAS scores among three groups during preoperative visit,preoperative waiting and anesthesia induction(P<0.05).Preoperative visit,preoperative waiting and anesthesia induction,the m-YPAS scores of the non coordination group were higher than those of the moderate coordination group and high coordination group,and those of the moderate coordination group were higher than those of the high coordination group,the differences were statistically significant(P<0.05).With the time of anesthesia approaching,the m-YPAS scores of the three groups increased(P<0.05).There was negative correlation between the level of anxiety during preoperative visit,preoperative waiting and anesthesia induction and the anesthesia induction cooperation degree(P<0.05).There were no significant differences in intraoperative blood loss,Remifentanil dosage,Propofol dosage,anesthesia time and surgical time among three groups(P>0.05).Before anesthesia,there were no significant differences in DBP,SBP and HR among three groups(P>0.05).After anesthesia,there were significant differences in DBP and SBP among three groups(P<0.05).After anesthesia,DBP and SBP of the non coordination group were higher than those of the moderate coordination group and high coordination group,the differences were statistically significant(P<0.05).30 min after surgery,there were significant differences in DBP among three groups(P<0.05).30 min after surgery,DBP of the non coordination group was higher than those of the moderate coordination group and the high coordination group,the differences were statistically significant(P<0.05).30 min after surgery,HR of the non coordination group was higher than those in the moderate coordination group and the high coordination group,the differences were statistically significant(P<0.05).Conclusion:General anesthesia surgery with preoperative anxiety level in different time and negatively correlated with anesthesia induction cooperation degree,and anesthesia induction cooperation degree difference although does not affect the surgery situation,but it will influence on the hemodynamics,so need to take scientific and reasonable measures,to reduce the general anesthesia surgery the patient’s anxiety level,anesthesia induction cooperation degree of ascension.