麻醉恢复室的成年患者全麻苏醒期躁动危险因素分析

Analysis on risk factors of emergence agitation in adult patients during recovery period after general anesthesia in postanesthesia care unit

目的探讨麻醉恢复室(PACU)的成年患者全麻苏醒期躁动(EA)危险因素。方法选择进入PACU进行全麻苏醒的择期手术患者2 056例,年龄大于18岁,性别不限,记录年龄、性别、体质量、ASA分级、术前合并疾病、受教育程度、术前用药、全麻方式、诱导使用咪达唑仑、麻醉时间、手术部位、手术种类、手术时间、术中出血量、术中补液量、PACU恢复时间、有无尿管、尿量、有无体温异常等。根据患者麻醉苏醒期是否发生躁动,分为安静组和躁动组。将组间差异有统计学意义的因素进行多因素Logistic回归分析,筛选麻醉苏醒期的危险因素。结果 127例患者在PACU的麻醉苏醒期发生躁动,发生率为6.18%。Logistic回归分析显示,ASA分级高、术中补液量大、安置尿管和术后疼痛是EA的危险因素(P<0.05)。结论 ASA分级高、术中补液量大、安置尿管和术后疼痛是EA的危险因素。

Objective To analyze the risk factors of emergence agitation（EA）in the adult patients during the recovery period after general anesthesia in postanesthesia care unit（PACU）.Methods 2 056 adult patients undergoing elective surgery under general anesthesia in PACU were selected,aged more than 18 years old,sex unlimited The following factors of age,gender,body mass,ASA grade,preoperative combined disease,education level,premedicatiou,general anesthesia mode,midazolam use for induction,anesthesia time,operation site,operation mode,operation time,intraoperative blood loss,intraoperative fluid replacement,recovery time in PACU,body temperature,urinary catheter,urine volume,etc.were recorded.According to whether EA occurring during recovery from general anesthesia,the patients were divided into the quiet group and the EA group.The multivariate Logistic regression was performed to analyze and screen the risk factors for the occurrence of EA.Results 127 cases developed EA during recovery from anesthesia.The occurrence rate of EA was 6.18%.The Logistic regression analysis indicated that high grade ASA,large quantity of intraoperative fluid replacement,placing urinary catheter and postoperative pain were the risk factors for EA（P〈0.05）.Conclusion Highgrade ASA,large quantity of intraoperative fluid replacement,placing urinary catheter and postoperative pain are the risk factors for EA during the recovery period after general anesthesia in PACU.