全麻腹腔镜下全子宫切除术患者麻醉复苏期躁动影响因素分析

Occurrence and the influencing factors of the agitation during anesthesia recovery after laparoscopic total hysterectomy under general anesthesia

目的:分析全麻腹腔镜下全子宫切除术(TLH)患者麻醉复苏期躁动(EA)的发生情况及影响因素。方法:回顾性收集2021年1月-2024年1月本院妇科收治的86例全麻TLH患者,根据是否发生EA分为EA组与非EA组,比较两组相关资料的差异性;运用logistic分析法分析EA的影响因素。结果:纳入的86例患者中发生EA18例,发生率为20.9%。EA组与非EA组ASA分级、合并糖尿病、神经阻滞、麻醉时间、手术时间、术中低体温、保温管理、低氧血症、肌松药残留、留置导尿管时机、术后VAS评分、术后镇痛、使用右美托咪定比较均有差异(P<0.05),两组年龄、体质指数、合并高血压情况等无差异(P>0.05)。logistic分析显示,合并糖尿病、麻醉时间长、手术时间长、术中低体温、低氧血症、肌松药残留、术后VAS评分高是发生EA的危险因素,ASA分级低、神经阻滞、保温管理、留置导尿管时机在术前、术后镇痛、使用右美托咪定是EA的保护因素(均P<0.05)。结论:本文调查的全麻TLH患者的EA发生率较高,影响因素较多,提示临床针对上述影响因素应采取积极预防措施,以降低EA的发生率,提高手术安全性。

Objective:To analyze the occurrence and the influencing factors of the agitation during anesthesia recovery of patients after laparoscopic total hysterectomy(LTH)under general anesthesia.Methods:86 patients with TLH under general anesthesia admitted to the hospital from January 2021 to January 2024 were collected and were divided into group A(patients with agitation during anesthesia recovery)and group B(patients without agitation during anesthesia recovery)based on whether the agitation occurred during anesthesia recovery or not.The differences of the relevant information of the patients were compared between the two groups.Logistic analysis was used to analyze the influencing factors of the agitation occurred of the patients during their anesthesia recovery.Results:In 86 patients,there were 18cases with the agitation occurred during anesthesia recovery,with an incidence of 20.9%.There were significant differences in the ASA classification,the complication with diabetes,the nerve block rate,the anesthesia time,the operation time,the intraoperative hypothermia rate,the heat preservation management,the hypoxemia rate,the residual rate of muscle relaxation drug,the timing of indwelling catheter,the postoperative VAS score,the postoperative analgesia status and dexmedetomidine used of the patients between the two groups(P<0.05).There were no significant differences in the age,the body mass index value and the hypertension rate of the patients between the two groups(P>0.05).Logistic analysis showed that the complication with diabetes mellitus,the long time of anesthesia and operation time,the low temperature,the hypoxemia,the muscle relaxants residues and the high score of postoperative VAS of the patients were the risk factors of their agitation occurred during anesthesia recovery.The low ASA grade,the nerve block,the heat preservation management,the timing of indwelling catheter before,the postoperative analgesia used and the dexmedetomidine used of the patients were the protective factors of their the agitation occurred during anesthesia recovery(all P<0.05).Conclusion:The incidence of the agitation occurred during anesthesia recovery of the patients with LTH under general anesthesia is higher,and which has many influencing factors.It is suggested that the clinical preventive measures based on these influencing factors should be taken to reduce the incidence of the agitation occurred during anesthesia recovery and improve the safety of surgery of the patients.