ABSTRACT
Objective To evaluate the efficacy of combination of multiple measures in preventing agitation during recovery from general anesthesia in the preschool children. Methods Four hundred and fifty preschool pediatric patients of both sexes, aged 3-6 yr, weighing 16-25 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective monocular strabismus surgery, were di-vided into 3 groups ( n=150 each) using a random number table method: routine prevention group ( groupⅠ) , midazolam-routine prevention group ( groupⅡ) and cartoon video-assisted admission to operating room-family members accompanying in postanesthesia care unit ( PACU)-routine prevention group ( groupⅢ) . Dexmedetomidine 0. 3μg∕kg was intravenously infused over 10 min in groupⅠ. On the basis of groupⅠ, midazolam 0. 05 mg∕kg was intravenously infused in the holding area in group Ⅱ, and children were admitted to the operating room while they were watching cartoons selected by themselves when accompanied by family members, and they were also accompanied by family members in PACU in group Ⅲ. The modi-fied Yale Preoperative Anxiety Scale score on admission to the operating room, Induction Compliance Checklist score, occurrence and degree of agitation during the recovery period, emergence time and dura-tion of PACU stay were recorded. Results Compared with groupⅠ, the modified Yale Preoperative Anxi-ety Scale score on admission to the operating room and Induction Compliance Checklist score were signifi-cantly decreased, and the incidence of agitation during the recovery period ( 25. 3％ in group Ⅰ, 12. 0％in group Ⅱ, 3. 3％ in group Ⅲ) was decreased in Ⅱ and Ⅲ groups , and the emergence time and dura-tion of PACU stay were significantly prolonged in groupⅡ( P<0. 05) . The incidence of agitation during the recovery period was significantly lower in group Ⅲ than in groupⅡ (P<0. 05). There was no significant difference in the constituent ratio of the degree of agitation among the three groups ( P>0. 05) . Conclusion Cartoon video-assisted admission to operating room-family members accompanying in PACU-routine pre-vention can effectively prevent the occurrence of agitation during recovery from general anesthesia in the pre-school children.
ABSTRACT
Objective To investigate the effect of cartoon video-assisted preoperative interview on the postoperative maladaptive behaviors of preschool pediatric patients.Methods One hundred preschool pediatric patients,aged 3-6 yr,weighing 12-28 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective strabismus surgery,were divided into 2 groups (n =50 each) using a random number table:cartoon video-assisted preoperative interview group (group Ⅰ) and routine preoperative interview group (group Ⅱ).In group Ⅰ,accompanied by the anesthesiologist,children and their parents watched the cartoon video designed for the perioperative process,and the anesthesiologist answered the questions that their parents had.After completion of tracheal intubation,dexmedetomidine 0.3 and 0.6 μg/kg were infused intravenously over 10 min in group Ⅰ and group Ⅱ,respectively.Three percent-4％ sevoflurane was inhaled to maintain anesthesia.The development and degree of agitation during stay in the post-anesthesia care unit (PACU) were recorded.The emergence time and length of PACU stay were also recorded.Postoperative maladaptive behaviors were assessed with the Post-Hospital Behavior Questionnaire at 1 week after surgery,and the occurrence of behavioral changes was recorded.Results Compared with group Ⅱ,the incidence of emergence agitation was significantly decreased,the degree of emergence agitation was reduced,the emergence time and length of PACU stay were shortened,and the incidence of behavioral changes (4％) was decreased after surgery in group Ⅰ (P＜0.05).Conclusion Cartoon video-assisted preoperative interview can effectively decrease the development of postoperative maladaptive behaviors of the preschool pediatric patients.
ABSTRACT
We aimed to investigate the effect of different controlled hypotension levels on myocardial enzymes and myocardial ischemia protein in elderly hypertension patients, and then provide clinical evidence of suitable controlled hypotension level for them. Then, 45 elderly hypertension patients received elective eye-nose related surgery with nasal endoscope, who were randomly and evenly divided into three groups, including A, B and C groups, with mean arterial pressure [MAP] decreased by 20%, 30% and 40% respectively. The change of myocardial enzymes, myocardial ischemia modified albumin, score of surgical field quality and 12-lead electrocardiogram at different perioperative points were recorded. Then operative time, urine output and postoperative adverse complications of the patients were recorded too. Myocardial enzymes of group C were higher than that of both group A and B at T4, T5 points [p<0.05]; Myocardial ischemia modified albumin of group C were higher than that of group A and B at T2, T3, T4 and T5 points [p<0.05]; The score of surgical field quality of group A were higher than that of group B and C [p<0.05]; Operation time of group C is less than that of group A and B [p< 0.05]; The change of ST segment in group C is more obvious than that in group A and B [p<0.05]; The incidence of adverse complications of group C is higher than that of group A and B [p<0.05]. Controlled hypotension with MAP reduced by 30% brings minimum myocardial damage and fewer complications, while meeting the demand of surgical field. Thus it is an ideal controlled hypotension level and can be used for elderly hypertension patients safely