Chung Frances, Kayumov Leonid, Sinclair David R, Edward Reginald, Moller Henry J, Shapiro Colin M
Department of Anesthesia, Toronto Western Hospital, University of Toronto, Ontario, Canada.
Anesthesiology. 2005 Nov;103(5):951-6. doi: 10.1097/00000542-200511000-00008.
Ambulatory surgical patients are advised to refrain from driving for 24 h postoperatively. However, currently there is no strong evidence to show that driving skills and alertness have resumed in patients by 24 h after general anesthesia. The purpose of this study was to determine whether impaired driver alertness had been restored to normal by 2 and 24 h after general anesthesia in patients who underwent ambulatory surgery.
Twenty patients who underwent left knee arthroscopic surgery were studied. Their driving simulation performance, electroencephalographically verified parameters of sleepiness, subjective assessment of sleepiness, fatigue, alertness, and pain were measured preoperatively and 2 and 24 h postoperatively. The same measurements were performed in a matched control group of 20 healthy individuals.
Preoperatively, patients had significantly higher attention lapses and lower alertness levels versus normal controls. Significantly impaired driving skills and alertness, including longer reaction time, higher occurrence of attention lapses, and microsleep intrusions, were found 2 h postoperatively versus preoperatively. No significantly differences were found in any driving performance parameters or electroencephalographically verified parameters 24 h postoperatively versus preoperatively.
Patients showed lower alertness levels and impaired driving skills preoperatively and 2 h postoperatively. Based on driving simulation performance and subjective assessments, patients are safe to drive 24 h after general anesthesia.
建议门诊手术患者术后24小时内不要开车。然而，目前尚无有力证据表明全身麻醉后24小时患者的驾驶技能和警觉性已恢复。本研究的目的是确定接受门诊手术的患者在全身麻醉后2小时和24小时其受损的驾驶员警觉性是否已恢复正常。
对20例行左膝关节镜手术的患者进行研究。在术前、术后2小时和24小时测量他们的驾驶模拟表现、脑电图验证的嗜睡参数、嗜睡、疲劳、警觉性和疼痛的主观评估。在20名健康个体组成的匹配对照组中进行相同的测量。
术前，与正常对照组相比，患者的注意力失误显著增加，警觉性水平较低。与术前相比，术后2小时发现驾驶技能和警觉性显著受损，包括反应时间延长、注意力失误发生率更高和微睡眠侵入。术后24小时与术前相比，任何驾驶性能参数或脑电图验证参数均未发现显著差异。
患者在术前和术后2小时表现出较低的警觉性水平和受损的驾驶技能。基于驾驶模拟表现和主观评估，患者在全身麻醉后24小时开车是安全的。
