Zhou Sihai,Gu Qian,Liu Xiaoli,et al.Risk factors of delayed recovery after general anesthesia in infants with neonatal necrotizing enterocolitis[J].Journal of Clinical Pediatric Surgery,,20():968-973.[doi:10.12260/lcxewkzz.2021.10.014]
Risk factors of delayed recovery after general anesthesia in infants with neonatal necrotizing enterocolitis
- Keywords:
- Enterocolitis; Necrotizing; Anesthesia; General; Delayed Emergence From Anesthesia; Risk Factors; Infant; Newborn
- CLC:
- R574.5;R614;R726.1
- Abstract:
- Objective To explore the risk factors of delayed recovery after general anesthesia in infants with neonatal necrotizing enterocolitis (NEC).Methods Clinical data were retrospectively analyzed for 213 NEC infants operated under general anesthesia from January 2012 to December 2019.They were divided into two groups of delayed (n=26) and normal (n=187) according to the definition that whether or not consciousness recovered in 90 min after an end of general anesthesia.Univariate and multivariate Logistic regressions were utilized for examining the risk factors of delayed recovery after general anesthesia in NEC infants.Results Delayed recovery occurred in 26/213 cases with an incidence of 12.2%.Univariate analysis showed that corrected gestational age, ASA classification, preoperative serum creatinine, intraoperative use of vasoactive agents, low nasopharyngeal temperature during operation, intestinal necrosis with perforation and lactic acid level at an end of anesthesia were the risk factors for the occurrence of delayed recovery (P<0.05).Logistic regression analysis indicated that preoperative serum creatinine (OR=1.081, 95%CI:1.042-1.122), low nasopharyngeal temperature during operation (OR=2.268, 95%CI:1.291-4.016) and lactic acid level at an end of anesthesia(OR=2.643, 95%CI:1.361-5.131)were independent determinants for the occurrence of delayed recovery (P<0.05).Receiver operating characteristic (ROC) curve was plotted by combining preoperative serum creatinine with lactate level after anesthesia.An area under the curve was 0.81(P<0.001) hinted at an excellent predictor for delayed postoperative recovery in NEC infants.Conclusion No single risk factor, rather a combination of factors may predict an onset of delayed recovery.Protection of vital organ functions, strengthening of heat preservation and maintenance of acid-base balance are important preventive measures of delayed recovery.
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Memo
收稿日期:2020-03-02。
基金项目:新疆维吾尔自治区自然科学基金（编号：2019D01A12）
通讯作者:阿里木江·阿不都热依木,Email:58078817@qq.com