儿童阻塞性睡眠呼吸暂停综合征手术苏醒期疼痛危险因素分析

doi:10.19438/j.cjoms.2023.02.013

中国口腔颌面外科杂志 ›› 2023, Vol. 21 ›› Issue (2): 175-179.doi: 10.19438/j.cjoms.2023.02.013

儿童阻塞性睡眠呼吸暂停综合征手术苏醒期疼痛危险因素分析

冯婉晴, 李静洁, 刘锦星^*, 劳蔚^*

上海交通大学医学院附属第九人民医院麻醉科,上海 200011

收稿日期:2022-10-23 修回日期:2022-11-24 出版日期:2023-03-20 发布日期:2023-06-12
通讯作者: 刘锦星,E-mail：liujinxing323@163.com;劳蔚,E-mail：jackielao17@163.com。^*共同通信作者
作者简介:冯婉晴(1989-),女,硕士,E-mail：fwanqing@163.com

Risk factors of postoperative pain after pediatric obstructive sleep apnea syndrome surgery in postanesthesia care unit

FENG Wan-qing, LI Jing-jie, LIU Jin-xing, LAO Wei

Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University. Shanghai 200011, China

Received:2022-10-23 Revised:2022-11-24 Online:2023-03-20 Published:2023-06-12

摘要/Abstract

摘要： 目的： 探讨儿童阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome,OSAS）手术后苏醒期疼痛的危险因素。方法： 纳入3—12岁择期行OSAS手术的患儿531例,记录患儿术前焦虑状态、家长焦虑状态、麻醉及手术相关信息、术后躁动及苏醒期疼痛程度,应用多因素Logistic回归分析苏醒期疼痛的危险因素。数据采用SAS 9.4软件进行统计学分析。结果： 患儿苏醒期中、重度疼痛发生率为16.6%,年龄（OR=0.85,95%CI: 0.76~0.95）、全扁桃体伴或不伴腺样体切除术（OR=1.5,95%CI: 1.12~1.99）、术前焦虑（OR=1.01,95%CI: 1.00~1.02）、术后躁动（OR=1.22,95%CI:1.17~1.26）及使用氯胺酮（OR=2.59,95%CI:1.53~4.41）与苏醒期疼痛评分独立相关。结论： 年龄、全扁桃体伴或不伴腺样体切除术、术前焦虑、术后躁动及使用氯胺酮是儿童OSAS手术后苏醒期疼痛的独立危险因素。

关键词: 儿童, 阻塞性睡眠呼吸暂停综合征, 腺样体扁桃体切除术, 苏醒期疼痛

Abstract: PURPOSE: To investigate the risk factors of postoperative pain in children after obstructive sleep apnea syndrome(OSAS) surgery. METHODS: A total of 531 children aged 3-12 years who underwent OSAS surgery were included. Children's preoperative anxiety state, parents' anxiety state, information related to anesthesia and surgery, postoperative agitation, postoperative pain during postanethesia care unit (PACU) were recorded. Multivariate logistic regression analysis was used to assess the risk factors of postoperative pain intensity. SAS 9.4 software was used for data analysis. RESULTS: The incidence of moderate to severe pain was 16.6% in PACU. Age(OR=0.85, 95%CI: 0.76-0.95), tonsillectomy with or without adenoidectomy (OR=1.5, 95%CI: 1.12-1.99), preoperative anxiety(OR=1.01, 95%CI: 1.00-1.02), emergence agitation (OR=1.22, 95%CI: 1.17-1.26) and ketamine use were independently associated with higher pain in PACU. CONCLUSIONS: Age,tonsillectomy with or without adenoidectomy, preoperative anxiety, emergence agitation and ketamine use are independent risk factors for postoperative pain in PACU.

Key words: Children, OSAS, Adenotonsillectomy, Postoperative pain in PACU

中图分类号:

R782.05.4

冯婉晴, 李静洁, 刘锦星, 劳蔚. 儿童阻塞性睡眠呼吸暂停综合征手术苏醒期疼痛危险因素分析[J]. 中国口腔颌面外科杂志, 2023, 21(2): 175-179.

FENG Wan-qing, LI Jing-jie, LIU Jin-xing, LAO Wei. Risk factors of postoperative pain after pediatric obstructive sleep apnea syndrome surgery in postanesthesia care unit[J]. China J Oral Maxillofac Surg, 2023, 21(2): 175-179.

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儿童阻塞性睡眠呼吸暂停综合征手术苏醒期疼痛危险因素分析

Risk factors of postoperative pain after pediatric obstructive sleep apnea syndrome surgery in postanesthesia care unit

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