摘要
目的:分析成人全身麻醉下鼻道手术苏醒期躁动(EA)的发生率及影响因素,为临床预防和控制EA提供依据。方法:随机选取并分析2013-02-2015-02期间住院治疗并行全身麻醉下鼻道手术的674例成年患者。依据镇静-躁动评分(SAS)对患者EA进行评定,并依据是否发生躁动分为对照组(518例)和EA组(156例)。分析人口学及临床相关指标对躁动发生的影响,并进行多元Logistic回归分析。结果:全身麻醉作用下鼻道手术患者EA发生率为23.15%。与对照组相比较,EA组患者在性别、年龄、ASA分级、吸烟史、脑血管病史、术前焦虑、使用咪达唑仑、麻醉方式、术后疼痛、术后镇痛、气管导管、留置尿管、苏醒方式等方面差异有统计学意义(P<0.05);多元Logistic回归结果表明,较轻的年龄、男性、术前焦虑、静吸复合麻醉、术后疼痛、气管插管及留置尿管为全身麻醉下鼻道手术患者EA发生的危险因素,年长者、配合使用咪达唑仑、全凭静脉麻醉、术后镇痛以及自然苏醒为保护性因素。结论:EA是成人全身麻醉下鼻道手术后的常见并发症,并与多种因素相关。临床应将具有以上危险因素的患者作为发生EA的高危群体重点关注,采取有效预防措施,保证患者平稳地度过苏醒期。
Objective：To identify the incidence and the risk factors for emergence agitation （EA） in adults undergoing general anesthesia for nasal surgery. Method：We examined 674 patients aged ≥18 years who underwent general anesthesia for nasal surgery between February 2013 and February 2015. The patients were divided into control group （518 cases） and EA group （156 cases） by Sedation-agitation scale （SAS） method. Demographic and clinical variables were assessed and the data were analyzed by multiple logistic regression analysis. Result： The overall incidence of emergence agitation was 23.15 % . Significant difference was observed between EA and the con trol group in many aspects, such as sex, age, ASA classify, smoking history, history of cerebrovascular disease, preoperative anxiety, the use of midazolam, anesthesia means, postoperative pain, postoperative analgesia, pres ence of a tracheal tube, and presence of a urinary catheter. The results of multiple logistic regression analysis indi- cated that the occurring of EA was significantly correlated with younger age, male, preoperative anxiety, inhalation anesthesia, postoperative pain, presence of a tracheal tube, and presence of a urinary catheter, while seniors, with the use of midazolam, total intravenous anesthesia, analgesia and natural awakening were protective factors. Conclusion：EA following general anesthesia is a common complication in patients with adult nasal surgery. To re duce the occurrence and consequences of agitation episodes, elimination of the associated risk factors is necessary, especially in patients with risk factors.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2015年第21期1881-1885,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
