无眼神交流和不知道周围环境的关联?

It is difficult to differentiate emergence delirium and pain in the clinical practice. Emergence delirium starts almost always during awakening and resolves within 15 min. When a child is unable to make‘eye contact’ and is‘unaware of the surroundings’ is more likely having emergence delirium rather than pain. The association of‘abnormal facial expression’,‘crying’, and‘inconsolability’ during the first 15 min after awakening better describes a child in pain. The practical problem is that almost half of children with emergence delirium will also have pain behavior during the early phases of awakening [19]. Therefore, the caregiver in the recovery room may struggle with the decision of giving a dose of opioid to treat pain, consoled the child or provide a dose of propofol to treat emergence delirium.

临床上很难鉴别苏醒期谵妄和疼痛。苏醒期谵妄几乎总是在苏醒期开始，并在15 min内消退。当儿童无法进行“眼神交流”和“不知道周围环境”时，更可能出现谵妄而不是疼痛。觉醒后前15分钟内“面部表情异常”、“哭闹”和“无法安慰”更可能是疼痛。但几乎一半的苏醒期谵妄儿童在觉醒早期也会有疼痛行为。因此，恢复室的医务人员可能难以决定是给予阿片类药物治疗疼痛、还是安慰儿童或提供一剂丙泊酚治疗苏醒期谵妄。

The association of no eye contact and unawareness of surroundings in children with pain behavior censored with a behavioral scale decreases significantly every 5 min. In the case of an unclear cause of the unsettling behavior, to console the child for 5 min may be the appropriate intervention. If the child is inconsolable, makes eye contact and seems oriented, pain may likely be the diagnosis and should be treated accordingly [20].

用行为量表检查疼痛儿童的行为时，无眼神交流和不知道周围环境的关联每5分钟显著下降。在不清楚不安行为的原因时，安抚孩子5分钟可能是合适的干预措施。如果儿童无法安慰，进行眼睛交流并看起来有方向感，疼痛可能是诊断结果，应进行相应治疗[20]。

无眼神交流和不知道周围环境的关联?有什么关联?又怎么会每5分钟显著下降？