全身麻醉中儿童梦境的影响因素以及右美托咪定对其影响
发布时间：2018-09-17 08:13
【摘要】：目的 探讨全身麻醉中儿童梦境的影响因素同时研究右美托咪定对儿童在全身麻醉期间对梦的影响。方法 1拟行骨科手术患儿200例,性别不限,ASA分级Ⅰ级,年龄5~12岁,体重指数15.2~18.1 kg/m2。PACU期间患儿苏醒、且定向力恢复时,采用改良Brice问卷调查梦的发生情况,如果有梦发生,采用Likert评分对梦境(梦境中的情绪、声音、动作,对梦的记忆程度)进行调查。2拟行骨科手术患儿400例,性别不限,ASA分级Ⅰ级,年龄5~12岁,体重指数15.2~18.1 kg/m2,根据计算机随机生成数字顺序,根据数字的奇偶性随机分为2组(n=200):对照组(C组)和右美托咪定组(D组)。D组麻醉诱导前经10 min静脉输注右美托咪定负荷量0.5μg/kg,随后以0.5μg·kg-1·h-1的速率静脉维持,C组给予等容量生理盐水。入PACU后待患儿苏醒、且定向力恢复时,采用改良Brice问卷调查梦的发生情况,采用Likert评分对梦境内容(梦境中的情绪、声音、动作及对梦的记忆程度)进行调查。结果 1儿童在全身麻醉中梦境发生率是22%。梦者的年龄与非梦者年龄相比较小(OR 0.77,OR的95%可信区间0.64-0.93),呼之睁眼时间(OR 0.91,OR的95%可信区间0.85-0.98)和定向力恢复时间(OR 0.93,OR的95%可信区间0.88-0.99)梦者相对较短,接受调查时的Narcotrend值较高(OR 1.13,OR的95%可信区间1.01-1.27),有统计学差异(P0.01),同时我们发现梦者平时做梦情况较非梦者要更为多见,有统计学意义(P0.05)。2 D组的梦的发生率9%,低于C组的发生率22%(OR 0.351,95%的可信区间0.195-0.632,;P0.01)。与C组比较,D组梦发生率降低,对梦境记忆程度评分降低(P0.05),梦境中情绪、声音和动作评分差异无统计学意义(P0.05)。同时苏醒期RAMSAY评分D组高于C组,有统计学意义(P0.05),躁动发生率D组8%明显低于C组30%,有统计学意义(P0.05)。两组术后满意度调查相比,D组的满意度高于C组,有统计学意义(P0.01).结论 总之,年龄越小、平时做梦频繁、苏醒期镇静深度越浅可能会报告出更多的梦境发生的情况;麻醉过程中发生梦境并不影响对手术过程的满意度;右美托咪定在儿童全身麻醉手术中应用可以使麻醉中的梦境发生率下降,但并不影响梦境中的内容,大多数都是积极的、愉快的;右美托咪定可以使术后苏醒躁动减少,患儿满意度上升。
[Abstract]:Objective to investigate the influencing factors of children's dreams during general anesthesia and to study the effects of dexmetomidine on children's dreams during general anesthesia. Methods 1Twenty two hundred children undergoing orthopedic surgery were enrolled in this study. The age was 5 to 12 years old, and the body mass index (BMI) was 15.21.When the recovery of orientation, the modified Brice questionnaire was used to investigate the occurrence of the dream, if there was a dream. Likert score was used to investigate 400 cases of children who planned orthopedic surgery (mood, voice, movement and memory of dreams). The age was 512 years old. The body mass index (BMI) of 15.2g 18.1 kg/m2, was randomly generated by the computer in numerical order, According to the number of parity, they were randomly divided into two groups: control group (group C) and dexmetomidine group (group D). Group D received intravenous infusion of dexmetomidine at a rate of 0.5 渭 g / kg for 10 min before anesthesia induction, then maintained the same volume of saline in group C at a rate of 0.5 渭 g / h ~ (-1). After entering PACU, the dream content (mood, voice, movement and memory level of dream) was investigated by modified Brice questionnaire. The content of dream (mood, voice, movement and memory of dream) was investigated by using modified Brice questionnaire. Results 1 the incidence of dreams in children under general anesthesia was 22. The age of dreamers was younger than that of non-dreamers (95% confidence interval of OR 0.77OR 0.64-0.93), the time of eye opening (95% confidence interval of OR 0.91 OR was 0.85-0.98) and the recovery time of orientation (95% confidence interval of OR 0.93OR 0.88-0.99). The Narcotrend value was higher (95% CI 1.01-1.27 of OR 1.13OR), and there was statistical difference (P0.01). At the same time, we found that the dreamers were more likely to dream than the non-dreamers. The incidence of dreams in group D was significantly lower than that in group C (P 0.05), which was lower than that in group C (OR 0.35195% CI 0.195-0.632P0.01). Compared with group C, the incidence of dreams in group D was lower, the score of dream memory was lower (P0.05), and there was no significant difference in scores of emotion, voice and action in dreams (P0.05). At the same time, RAMSAY score in group D was significantly higher than that in group C (P0.05). The incidence of restlessness in group D was significantly lower than that in group C (P 0.05). Compared with group D, the satisfaction of group D was higher than that of group C (P 0.01). Conclusion in short, the younger the age, the more frequent dreams, the lower the sedation depth during the recovery period, the more the occurrence of dreams may be reported, and the occurrence of dreams during anesthesia does not affect the satisfaction of the operation process. The use of dexmetomidine in children undergoing general anesthesia can reduce the incidence of dreams in anesthesia, but it does not affect the content of dreams, most of them are positive and pleasant, and dexmetomidine can reduce postoperative recovery and restlessness. Children's satisfaction increased.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.1
本文编号：2245267
[Abstract]:Objective to investigate the influencing factors of children's dreams during general anesthesia and to study the effects of dexmetomidine on children's dreams during general anesthesia. Methods 1Twenty two hundred children undergoing orthopedic surgery were enrolled in this study. The age was 5 to 12 years old, and the body mass index (BMI) was 15.21.When the recovery of orientation, the modified Brice questionnaire was used to investigate the occurrence of the dream, if there was a dream. Likert score was used to investigate 400 cases of children who planned orthopedic surgery (mood, voice, movement and memory of dreams). The age was 512 years old. The body mass index (BMI) of 15.2g 18.1 kg/m2, was randomly generated by the computer in numerical order, According to the number of parity, they were randomly divided into two groups: control group (group C) and dexmetomidine group (group D). Group D received intravenous infusion of dexmetomidine at a rate of 0.5 渭 g / kg for 10 min before anesthesia induction, then maintained the same volume of saline in group C at a rate of 0.5 渭 g / h ~ (-1). After entering PACU, the dream content (mood, voice, movement and memory level of dream) was investigated by modified Brice questionnaire. The content of dream (mood, voice, movement and memory of dream) was investigated by using modified Brice questionnaire. Results 1 the incidence of dreams in children under general anesthesia was 22. The age of dreamers was younger than that of non-dreamers (95% confidence interval of OR 0.77OR 0.64-0.93), the time of eye opening (95% confidence interval of OR 0.91 OR was 0.85-0.98) and the recovery time of orientation (95% confidence interval of OR 0.93OR 0.88-0.99). The Narcotrend value was higher (95% CI 1.01-1.27 of OR 1.13OR), and there was statistical difference (P0.01). At the same time, we found that the dreamers were more likely to dream than the non-dreamers. The incidence of dreams in group D was significantly lower than that in group C (P 0.05), which was lower than that in group C (OR 0.35195% CI 0.195-0.632P0.01). Compared with group C, the incidence of dreams in group D was lower, the score of dream memory was lower (P0.05), and there was no significant difference in scores of emotion, voice and action in dreams (P0.05). At the same time, RAMSAY score in group D was significantly higher than that in group C (P0.05). The incidence of restlessness in group D was significantly lower than that in group C (P 0.05). Compared with group D, the satisfaction of group D was higher than that of group C (P 0.01). Conclusion in short, the younger the age, the more frequent dreams, the lower the sedation depth during the recovery period, the more the occurrence of dreams may be reported, and the occurrence of dreams during anesthesia does not affect the satisfaction of the operation process. The use of dexmetomidine in children undergoing general anesthesia can reduce the incidence of dreams in anesthesia, but it does not affect the content of dreams, most of them are positive and pleasant, and dexmetomidine can reduce postoperative recovery and restlessness. Children's satisfaction increased.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.1
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