An Investigation of the Pediatric Rigid Bronchoscopy Complication with Three Different Anesthesia Regimes.

Q2 Medicine
Anesthesiology and Pain Medicine Pub Date : 2024-09-28 eCollection Date: 2024-08-01 DOI:10.5812/aapm-150953
Tahereh Chavoshi, Faranak Rokhtabnak, Nasrin Nouri, Seyedbabak Mojaveraghili, Alireza Eshghi, Reza Salehi
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Abstract

Background: Foreign body aspiration is common in children and poses a significant risk of morbidity and mortality. Rigid bronchoscopy is the most common method for removing aspirated foreign bodies.

Objectives: Anesthesiologists play a critical role in managing these procedures, aiming to find the best strategies with the fewest complications. This study aims to compare anesthesia-related complications during rigid bronchoscopy in children using muscle relaxants versus no muscle relaxants.

Methods: In this clinical trial, 60 eligible children were randomly divided into three equal groups: SP: Spontaneous ventilation with sevoflurane and propofol; VA: Controlled ventilation with sevoflurane and atracurium; VR: Controlled ventilation with sevoflurane and rocuronium. At the end of anesthesia, complications such as cough, bucking, hypoxemia, laryngospasm, and bronchospasm were compared, along with the pulmonologist's level of satisfaction, surgery duration, and total anesthesia time in the three groups.

Results: The comparison between the SP, VR, and VA groups revealed the following: No significant difference was found in the incidence of cough and respiratory distress following foreign body aspiration among the three groups (P = 0.262 and P = 0.762, respectively); minimum oxygen saturation during rigid bronchoscopy differed significantly between the groups (P = 0.013); bucking during bronchoscopy was significantly more frequent in the SP group (P = 0.017); laryngospasm was significantly more common in the SP group compared to the other two groups (P = 0.004); agitation during recovery was significantly lower in the propofol (SP) group; pulmonologist satisfaction was highest in the VR group, followed by the VA group, with a significant difference compared to the SP group (P = 0.021); although the SP group experienced more frequent hypoxemia, the difference was not statistically significant; there was no significant difference in anesthesia or bronchoscopy duration across the three groups.

Conclusions: The study results suggest that using muscle relaxants in rigid bronchoscopy offers several advantages, including fewer intraoperative complications such as bucking and laryngospasm. Additionally, controlled ventilation reduced the need for intravenous anesthetics and opioids, minimizing adverse effects and shortening recovery times.

三种麻醉方式下小儿刚性支气管镜并发症的研究。
背景:儿童异物误吸是一种常见的疾病,具有很高的发病率和死亡率。刚性支气管镜检查是清除吸入异物最常用的方法。目的:麻醉师在管理这些手术中发挥关键作用,旨在找到并发症最少的最佳策略。本研究旨在比较使用肌肉松弛剂和未使用肌肉松弛剂的儿童在刚性支气管镜检查时的麻醉相关并发症。方法:在本临床试验中,60例符合条件的儿童随机分为三组:SP组:七氟醚和异丙酚自发通气;VA:用七氟醚和阿曲库铵控制通风;VR:七氟醚和罗库溴铵控制通气。在麻醉结束时,比较三组患者的并发症,如咳嗽、屈曲、低氧血症、喉痉挛和支气管痉挛,以及肺科医生的满意度、手术持续时间和总麻醉时间。结果:SP组、VR组和VA组比较:三组患者吸异物后咳嗽和呼吸窘迫发生率无显著差异(P = 0.262、P = 0.762);刚性支气管镜检查时最低血氧饱和度组间差异有统计学意义(P = 0.013);SP组支气管镜检查时屈曲发生率显著高于对照组(P = 0.017);SP组喉痉挛发生率明显高于其他两组(P = 0.004);异丙酚(SP)组恢复期躁动明显降低;肺科医生满意度以VR组最高,VA组次之,与SP组比较差异有统计学意义(P = 0.021);SP组低氧血症发生率较高,但差异无统计学意义;三组麻醉时间和支气管镜检查时间无显著差异。结论:研究结果表明,在刚性支气管镜检查中使用肌肉松弛剂有几个优点,包括较少术中并发症,如屈曲和喉痉挛。此外,控制通气减少了静脉麻醉剂和阿片类药物的需要,最大限度地减少了不良反应,缩短了恢复时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Anesthesiology and Pain Medicine
Anesthesiology and Pain Medicine Medicine-Anesthesiology and Pain Medicine
CiteScore
4.60
自引率
0.00%
发文量
49
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