Mattila Kristiina, Toivonen Juhani, Janhunen Leena, Rosenberg Per H, Hynynen Markku
*Department of Anesthesiology and Intensive Care Medicine, Jorvi Hospital, Helsinki University Central Hospital, Espoo, Finland; †Department of Anesthesiology and Intensive Care Medicine, Meilahti Hospital, Helsinki University Central Hospital, Helsinki, Finland; and ‡Department of Anesthesiology, South Carelian Central Hospital, Lappeenranta, Helsinki, Finland.
Anesth Analg. 2005 Dec;101(6):1643-1650. doi: 10.1213/01.ANE.0000184189.79572.28.
Minor sequelae, such as pain, nausea, and drowsiness, often occur in surgical outpatients in the immediate postdischarge period. In this prospective, observational study was defined the daily incidence and intensity of several symptoms during the first week after surgery and determined predictive factors of minor morbidity. In two similar mixed ambulatory surgery units, 3910 patients received a questionnaire to grade daily the intensity of predefined symptoms on a 4-point scale. Multinomial logistic regression was used to analyze risk factors, with adults and children as separate groups. Of these patients, 2754 (70%) responded. Patients experienced numerous minor sequelae during the first week after ambulatory surgery. Symptoms were common (up to 86% of all patients) on the initial days after surgery and were still reported by 24% of adults on the postoperative Day 7. In adults, pain was the most common symptom and, in comparison with other symptoms, was more often moderate or severe. Drowsiness was most common in children. Younger adults, older children, and women were more prone to experience minor morbidity. Longer duration of surgery led to increased likelihood of pain and nausea in all patients and increased the risk of several other symptoms in adults.
轻微后遗症,如疼痛、恶心和嗜睡,常在外科门诊患者出院后的即刻出现。在这项前瞻性观察研究中,确定了术后第一周内几种症状的每日发生率和严重程度,并确定了轻微发病的预测因素。在两个类似的混合门诊手术科室,3910名患者收到一份问卷,要求他们用4分制对预先定义症状的严重程度进行每日评分。采用多项逻辑回归分析危险因素,将成人和儿童分为不同组。这些患者中,2754名(70%)进行了回复。门诊手术后第一周,患者出现了众多轻微后遗症。症状在术后最初几天很常见(所有患者中高达86%),术后第7天仍有24%的成人报告有症状。在成人中,疼痛是最常见的症状,与其他症状相比,疼痛更常为中度或重度。嗜睡在儿童中最常见。年轻成人、大龄儿童和女性更容易出现轻微发病。手术时间延长会增加所有患者疼痛和恶心的可能性,并增加成人出现其他几种症状的风险。