普外科患者全麻术后苏醒期躁动的危险因素

Risk Factors of Agitation in General Surgery Patients after General Anesthesia Surgery

目的:探讨普外科患者全麻术后苏醒期躁动的危险因素。方法:回顾性选取2018年1月-2021年12月广州中医药大学第二附属医院手术室全麻下行手术治疗的普外科患者168例。采用Riker镇静-躁动评分(SAS)评估患者术后麻醉苏醒期是否存在躁动,并根据SAS评分结果将患者分为躁动组和非躁动组,收集所有患者的一般资料。统计分组情况,对全麻术后苏醒期躁动进行单因素和多因素分析。结果:168例患者中,躁动组42例,非躁动组126例,躁动发生率为25.00%。躁动组年龄≥60岁、合并基础疾病、术前焦虑、ASA分级Ⅲ级、静吸复合麻醉、术中低体温、术后低氧血症、肌松药残留、术后VAS评分>4分、留置尿管占比均高于非躁动组,术后镇痛占比低于非躁动组(P<0.05)。ASA分级、年龄≥60岁、术前焦虑、留置尿管、术后VAS评分>4分是全麻术后苏醒期躁动的危险因素,术后镇痛是全麻术后苏醒期躁动的保护因素(P<0.05)。结论:对ASA分级高、年龄≥60岁、术前焦虑、留置尿管、术后VAS评分>4分患者应积极进行术后镇静镇痛,预防术后躁动的发生。

Objective:To investigate the risk factors of agitation in general surgery patients after general anesthesia surgery.Method:From January 2018 to December 2021,168 cases of general surgery patients treated by surgery under general anesthesia in the operating room of the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine were retrospectively selected.Riker sedation agitation score(SAS)was used to evaluate whether there was agitation in the postoperative anesthesia recovery period,and the patients were divided into agitation group and non agitation group according to the SAS score results,and the general data of all patients were collected.The grouping situation was counted,and the univariate and multivariate analysis for agitation during recovery period after general anesthesia surgery were carried out.Result:Among 168 patients,there were 42 cases in the agitation group and 126 cases in the non agitation group,and the incidence of agitation was 25.00%.The proportions of age≥60 years old,combined with basic diseases,preoperative anxiety,ASA gradeⅢ,intravenous inhalation combined anesthesia,intraoperative hypothermia,postoperative hypoxemia,muscle relaxant residues,postoperative VAS score>4 points,indwelling catheter of agitation group were higher than that of non agitation group,and the proportion of postoperative analgesia was lower than that of non agitation group(P<0.05).ASA grade,age≥60 years old,preoperative anxiety,indwelling catheter,and postoperative VAS score>4 points were the risk factors of agitation in the recovery period after general anesthesia surgery,and postoperative analgesia was the protective factor for agitation in the recovery period after general anesthesia surgery(P<0.05).Conclusion:For patients with high ASA grade,age≥60 years old,preoperative anxiety,indwelling catheter,and postoperative VAS score>4 points,postoperative sedation and analgesia should be actively carried out to prevent the occurence of postoperative agitation.