全身麻醉患者苏醒期躁动危险因素分析

Analysis of Risk Factors of Emergence Agitation in Patients Undergoing General Anesthesia during Analepsia Stage

目的分析全身麻醉苏醒期躁动(emergence agitation,EA)发生的相关危险因素。方法回顾性分析2015年1月—2015年12月就诊的800例全身麻醉苏醒期患者的临床资料,统计苏醒期躁动发生率。以是否发生躁动为依据分为躁动组、非躁动组,对两组的临床资料行单因素、Logistic多因素回归分析。结果 EA发生率为6.25%。躁动组与非躁动组在糖尿病、导尿管留置、麻醉诱导后导尿管留置、全身麻醉方式、手术类型、术后贫血、术后疼痛、术后镇痛、手术时间以及麻醉恢复室停留时间方面比较,差异有统计学意义(P<0.05,P<0.01)。Logistic多因素回归分析表明导尿管留置、手术类型、全身麻醉方式和术后疼痛为全身麻醉患者EA发生的独立危险因素(P<0.05,P<0.01),而术后镇痛为保护因素(P<0.01)。结论影响全身麻醉患者苏醒期躁动发生因素较多,需采取针对性、全面干预措施预防EA发生。

Objective To analyze related risk factors of emergence agitation （ EA） in patients undergoing gener-al anesthesia during analepsia stage. Methods Clinical data of 800 patients undergoing general anesthesia during an-alepsia stage from January to December 2015 was retrospectively analyzed and EA incidence rate was statistically ana-lyzed. According to whether being EA or not, patients were divided into agitation and non-agitation groups. Univariate and logistic multivariate regression analyses were performed for clinical data in two groups. Results EA incidence rate was 6. 25%. There were significant differences in diabetes mellitus, catheter indwelling, catheter indwelling after anes-thesia induction, methods of general anesthesia, surgical types, postoperative anemia, pain and analgesia, operation time and length of stay during anesthetic recovery room in two groups （P〈0. 05, P〈0. 01）. Logistic multivariate regression analysis showed that catheter indwelling, surgical types, methods of general anesthesia and postoperative pain were inde-pendently risk factors （P〈0. 05, P〈0. 01）, while postoperative analgesia was a protective factor of EA in patients un-dergoing general anesthesia （ P〈0. 01 ） . Conclusion Many factors can affect EA pathogenesy in patients undergoing general anesthesia and corresponding and comprehensive intervention measures should be given to prevent EA incidence.