全麻手术患者术中知晓的影响因素

The influence factors of intraoperative awareness during surgery under general anesthesia

目的:探讨接受全身麻醉的择期手术患者术中知晓的发生率及其影响因素。方法:回顾性分析2884例接受全麻的择期手术患者的临床资料,根据术中知晓情况不同将患者分为无知晓+可疑知晓组(n=2871)与知晓组(n=13),记录并比较患者一般情况,术中记录患者的手术情况及麻醉信息;术后1、3 d对患者进行术中知晓进行随访,将患者的一般情况、手术信息及麻醉信息与术中知晓的发生情况进行单因素分析,筛选出差异具有统计学意义的因素后应用多因素Logistic回归分析全身麻醉下术中知晓的影响因素。结果:研究对象中,明确知晓13例,术中知晓的发生率为0.5%。Logistic回归分析结果显示,采用喉罩通气(OR=7.031)及体质量指数(BMI)(OR=1.167)是影响术中知晓的危险因素(P<0.05)。结论:术中知晓的发生率为0.5%,采用喉罩通气及高BMI的患者发生术中知晓的风险较高,值得临床重点关注。

Objective:To analyze the incidence and the influence factors of intraoperative awareness by including elective surgical patients undergoing general anesthesia.Methods:2,884 elective surgical patients received general anesthesia were retrospectively analyzed,and they were divided into the no knowing+suspicious knowing group(n=2,871)and the knowing group(n=13)according to the different knowing conditions during the operation.The patient's general condition was recorded and compared,and the patient's surgical condition and anesthesia information during surgery were recorded.Followed up on intraoperative awareness of patients 1 and 3 days after surgery,the general conditions,perioperative data and anesthetic drugs were collected to analyze influence factors.Logistic regression model was used to analyze the risk factors that may have led to intraoperative awareness.Results:Among the study subjects,13 patients(0.5%)were reported confirmed awareness.The results of Logistic regression analysis showed that the use of laryngeal mask ventilation(OR=7.031)and body mass index(BMI)(OR=1.167)were risk factors affecting intraoperative awareness(P<0.05).Conclusion:The incidence of intraoperative awareness is 0.5%.The using of laryngeal mask airway and high BMI index are the risk factors of intraoperative awareness,which is worthy of clinical attention.