外科儿科患者全麻诱导后心动过缓的患病率及相关因素。前瞻性观察研究。

IF 1.7 Q2 PEDIATRICS Pediatric health, medicine and therapeutics Pub Date : 2023-11-06 eCollection Date: 2023-01-01 DOI:10.2147/PHMT.S429321
Tajera Tageza Ilala, Gudeta Teku Ayano, Minda Abebe Seife, Mengistu Yinges Kebede, Belete Alemu Geleta, Kidanemariam Tamrat Yilma
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引用次数: 0

摘要

背景:心率是儿童出生第一年心输出量的主要决定因素。因此,心动过缓减少心输出量,导致致命性心律失常、心脏骤停,甚至死亡。本研究的目的是确定在哈瓦萨大学综合专科医院(HUCSH)手术的儿科患者全麻诱导后心动过缓的患病率及其相关因素。方法:采用系统随机抽样方法进行前瞻性观察研究。6岁以下的儿科外科患者被纳入研究。数据输入Epi数据统计软件(4.6.0版本),导出到SPSS软件(25.0版本)。分类资料采用卡方统计,连续资料采用t检验。采用双变量逻辑回归选择多变量逻辑回归的候选变量。结果:本研究纳入的205例儿科患者中,心动过缓的患病率为19.5%。术前缺氧、阿片类药物预用药、吸入诱导(氟烷)、插管困难、术中并发症和大量手术失血的风险与心动过缓独立相关。结论:全麻诱导后心动过缓发生率为19.5%。术前缺氧、阿片类药物预用药、吸入诱导(特别是氟烷)、插管困难、术中并发症(如缺氧)和大量失血的风险与心动过缓显著相关。
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Prevalence of Bradycardia After Induction of General Anesthesia and Associated Factors Among Surgical Pediatric Patients. A Prospective Observational Study.

Background: Heart rate is the main determinant factor of the child's cardiac output in the first year of life. Thus, bradycardia decreases cardiac output leading to fatal cardiac arrhythmias, cardiac arrest, and even death. The objective of this study is to determine the prevalence of bradycardia and its associated factors after induction of general anesthesia among pediatric patients operated at Hawassa University Comprehensive Specialized Hospital (HUCSH).

Methods: Prospective observational study was employed at HUCSH by using a systematic random sampling technique. Pediatric surgical patients less than 6 years old were included in the study. Data were entered into Epi data statistical software (version 4.6.0.) and exported to SPSS (version 25.0). Categorical data were analyzed using chi-square statistics, and continuous data were analyzed using Student's t-test. Bivariable logistic regression was used to select candidate variables for multivariable logistic regression.

Results: The prevalence of bradycardia among 205 pediatric patients included in this study was 19.5%. Preoperative risk of hypoxia, opioids premedication, inhalational induction (halothane), difficult intubation, intraoperative complications, and significant surgical blood loss were independently associated with bradycardia.

Conclusion: The prevalence of bradycardia after induction of general anesthesia was 19.5%. Preoperative risk of hypoxia, opioids premedication, inhalational induction (particularly with halothane), difficult intubation, intraoperative complications such as hypoxia, and significant blood loss were significantly associated with bradycardia.

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