Kim Hyun-Chang, Kim Eugene, Jeon Young-Tae, Hwang Jung-Won, Lim Young-Jin, Seo Jeong-Hwa, Park Hee-Pyoung
Department of Anaesthesia and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Anaesthesia and Pain Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
J Int Med Res. 2015 Apr;43(2):226-35. doi: 10.1177/0300060514562489. Epub 2015 Jan 30.
To investigate the incidence and risk factors for emergence agitation in the postanaesthetic care unit (PACU), in adult patients undergoing urological surgery.
Medical records were retrospectively reviewed. Preoperative, intraoperative and postoperative variables were evaluated. Emergence agitation was defined as a Riker sedation-agitation score ≥ 5. Logistic regression analysis was used to determine independent risk factors for emergence agitation.
Emergence agitation was observed in 48/488 (9.8%) patients. Chronic lung disease (odds ratio [OR] 2.72, 95% confidence interval [CI] 1.03, 7.17), duration of surgery (OR 1.01, 95% CI 1.00, 1.01), history of social drinking (OR 2.48, 95% CI 1.25, 4.93), postoperative pain score (OR 1.32, 95% CI 1.14, 1.53), voiding urgency (OR 2.20, 95% CI 1.01, 4.77) and presence of gastric tube (OR 2.85, 95% CI 1.07, 7.54) were independent risk factors for emergence agitation.
Adequate postoperative pain management and prevention of catheter-related bladder discomfort may be helpful in reducing the incidence of emergence agitation in urology patients.
调查泌尿外科手术成年患者在麻醉后护理单元（PACU）出现苏醒期躁动的发生率及危险因素。
对病历进行回顾性分析。评估术前、术中和术后变量。将苏醒期躁动定义为里克尔镇静 - 躁动评分≥5分。采用逻辑回归分析确定苏醒期躁动的独立危险因素。
488例患者中有48例（9.8%）出现苏醒期躁动。慢性肺部疾病（比值比[OR]2.72，95%置信区间[CI]1.03，7.17）、手术时间（OR 1.01，95%CI 1.00，1.01）、社交性饮酒史（OR 2.48，95%CI 1.25，4.93）、术后疼痛评分（OR 1.32，95%CI 1.14，1.53）、排尿急迫感（OR 2.20，95%CI 1.01，4.77）和胃管留置情况（OR 2.85，95%CI 1.07，7.54）是苏醒期躁动的独立危险因素。
充分的术后疼痛管理及预防导尿管相关膀胱不适可能有助于降低泌尿外科患者苏醒期躁动的发生率。
