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牙买加金斯敦一家教学医院中,择期妇科和骨科手术患者术后与麻醉相关的轻微并发症

Minor postoperative complications related to anesthesia in elective gynecological and orthopedic surgical patients at a teaching hospital in Kingston, Jamaica.

作者信息

Tennant Ingrid, Augier Richard, Crawford-Sykes Annette, Ferron-Boothe Doreen, Meeks-Aitken Nicola, Jones Karen, Gordon-Strachan Georgiana, Harding-Goldson Hyacinth

机构信息

Department of Surgery Radiology, Anesthesia and Intensive Care, University of the West Indies, Kingston 7, Mona, Jamaica.

出版信息

Rev Bras Anestesiol. 2012 Mar-Apr;62(2):188-98. doi: 10.1016/S0034-7094(12)70117-4.

DOI:10.1016/S0034-7094(12)70117-4
PMID:22440374
Abstract

BACKGROUND AND OBJECTIVES

Minor postoperative anesthetic complications may increase patient discomfort and dissatisfaction and delay recovery. This paper sought to determine the frequency of minor complications in the first 48 hours postoperatively reported by elective gynecological and orthopedic surgical patients at the University Hospital of the West Indies, Jamaica. Overall satisfaction with anesthetic care and possible risk factors for developing complications were also assessed.

METHODS

A prospective, descriptive cohort study was undertaken with patient interviews 24 to 48 hours after anesthesia. Data were analyzed using SPSS version 12 and assessed using the χ(2)-square test and multiple logistic regression models.

RESULTS

Five hundred and five (505) patients were included, with 374 females (74%). Most were ASA I (55%) or ASA II (38%) and had general anesthesia (80%). A total of 419 (83%) patients reported at least one complication postoperatively. The most frequently reported complications were sore throat (44%), nausea (30%), vomiting (24%), and thrombophlebitis (20%). The mode of the Verbal Numerical Rating Score (VNRS) for each complication ranged between 2 and 5, suggesting that most did not cause severe distress. Age less than 45 years (OR 2.22, 95% CI 1.34-3.69, p=0.002) and female gender (OR 3.64, 95% CI 2.14-6.20, p<0.001) were identified as significant independent variables. Most patients regarded their anesthetic experience as excellent (51%) or very good (22%).

CONCLUSION

This study showed a comparatively high incidence of minor postoperative complications (83%), but low reported severity of symptoms and a high overall satisfaction rate. Special attention should be paid to reduce these minor complications through more meticulous anesthetic technique.

摘要

背景与目的

术后轻微麻醉并发症可能会增加患者的不适与不满,并延迟康复。本文旨在确定牙买加西印度大学医院择期妇科和骨科手术患者术后48小时内轻微并发症的发生率。同时还评估了患者对麻醉护理的总体满意度以及发生并发症的可能风险因素。

方法

采用前瞻性描述性队列研究,在麻醉后24至48小时对患者进行访谈。使用SPSS 12版软件进行数据分析,并采用卡方检验和多元逻辑回归模型进行评估。

结果

共纳入505例患者,其中女性374例(74%)。大多数患者为ASA I级(55%)或ASA II级(38%),接受全身麻醉(80%)。共有419例(83%)患者术后报告至少一种并发症。最常报告的并发症为咽痛(44%)、恶心(30%)、呕吐(24%)和血栓性静脉炎(20%)。每种并发症的言语数字评定量表(VNRS)评分在2至5分之间,表明大多数并发症并未引起严重不适。年龄小于45岁(OR 2.22,95%CI 1.34 - 3.69,p = 0.002)和女性(OR 3.64,95%CI 2.14 - 6.20,p < 0.001)被确定为显著的独立变量。大多数患者认为其麻醉体验为优秀(51%)或非常好(22%)。

结论

本研究显示术后轻微并发症的发生率相对较高(83%),但报告的症状严重程度较低,总体满意度较高。应通过更精细的麻醉技术特别关注减少这些轻微并发症。

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