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小儿全麻术后苏醒期躁动是指患儿麻醉苏星期出现的一种意识与行为分离的精神状态。表现为无法安抚、易激惹、倔强或不合作,典型者会出现哭喊、手脚乱动、呻吟、语无伦次、定向障碍及偏执狂的精神状态等~([1])。会导致手术创面渗血,苏醒延迟,严重的会导致循环不稳定,血压升高、心率增快等并发症,增加了围手术期的风险度。由于小儿生理及心理的特殊性其苏醒期躁动的发生率很高,国外报道约为12%~13%~([2])。其发病因素和机制非常复杂,是多种因素共同作用的结果~([3])。原因可能与苏醒迅速、疼痛、七氟醚的内在反应、患者年龄、性格、麻醉的时间及麻醉深度、手术类型、手术室环境的刺激以及辅助使用的药物等有关。镇痛完善、术前用药,心理干预等可能降低小儿术后躁动的发生率。
Recovery of pediatric anesthesia after restlessness refers to the emergence of anesthesia in children with a consciousness and behavior of the mental state of separation. It can not be comforted, irritable, stubborn or uncooperative. Typical people may experience cries, hands and feet, moaning, incoherent, disorientation and paranoid mental states. [1] Will lead to surgical wound bleeding, wake up delay, serious will lead to unstable circulation, high blood pressure, heart rate and other complications, increased perioperative risk. Because of the special physiological and psychological characteristics of children, the incidence of restlessness is very high, about 12% ~ 13% ~ ([2]). Its pathogenesis and mechanism are complex and result from the combination of multiple factors ~ ([3]). Reasons may be related to rapid recovery, pain, intrinsic response to sevoflurane, patient’s age, personality, time of anesthesia and depth of anesthesia, type of surgery, stimulation of operating room environment, and auxiliary drugs. Perfect analgesia, preoperative medication, psychological intervention may reduce the incidence of postoperative agitation in children.