Bogod D G, Orton J K, Yau H M, Oh T E
Chinese University of Hong Kong, Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Shatin, New Territories.
Anaesthesia. 1990 Apr;45(4):279-84. doi: 10.1111/j.1365-2044.1990.tb14732.x.
Seventy-four patients received general anaesthesia for Caesarean section. Seven percent of the elective group and 28% of the emergency patients reported dreaming or recall of voices during the procedure (p less than 0.05) at postoperative interview. One patient from each group reported feeling pain or suffocation. All patients were monitored for awareness using the isolated forearm technique and lower oesophageal contractility. Provoked lower oesophageal contractility was the most effective of the different indices. A value greater than 35 mmHg on at least one occasion had a false negative rate of 33%, a false positive rate of 28% and a predictive value of 25%. A value greater than 13 mmHg picked up all patients who dreamed, with a false positive rate of 68%. Both of the 'aware' patients had provoked lower oesophageal contractility response of greater than 70 mmHg, an attribute shared by only 8% of the rest. The isolated forearm was particularly ineffective.
74例患者接受剖宫产全身麻醉。术后访视时，择期手术组有7%的患者和急诊手术患者中有28%的患者报告在手术过程中做梦或回忆起声音（p<0.05）。每组各有1例患者报告感到疼痛或窒息。所有患者均采用孤立前臂技术和食管下段收缩性监测意识。在不同指标中，诱发食管下段收缩性是最有效的。至少有一次大于35 mmHg的值假阴性率为33%，假阳性率为28%，预测值为25%。大于13 mmHg的值能检测出所有做梦的患者，假阳性率为68%。两名“有知晓”的患者食管下段收缩性诱发反应均大于70 mmHg，其余患者中只有8%有此特征。孤立前臂技术特别无效。
