Tsukamoto Masanori, Hitosugi Takashi, Esaki Kanako, Yokoyama Takeshi
Department of Dental Anesthesiology, Kyushu University Hospital, Fukuoka, Japan.
Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
J Dent Anesth Pain Med. 2016 Sep;16(3):193-197. doi: 10.17245/jdapm.2016.16.3.193. Epub 2016 Sep 30.
Some patients with special needs exhibit intellectual disability, including deficits in cognitive skills and decreased quality of life. The purpose of this study was to retrospectively compare changes in body composition and hemodynamics during general anesthesia in patients with and without special needs.
The backgrounds of patients who underwent oral maxillofacial surgery under general anesthesia were recorded from medical records. Intracellular water (ICW), extracellular water (ECW), stroke volume variation (SVV), and heart rate (HR) were recorded for 3 h after the start of anesthesia. Categorical data were compared using an unpaired t-test, and a P-value of less than 0.05 was regarded as significant. Numerical data were compared using the Bonferroni correction, and a P-value of less than 0.0125 was regarded as significant.
A total of 21 patients were included in the study: 10 patients without special needs (non-S-group) and 11 patients with special needs (S-group). There were no significant differences in patients' backgrounds, except with regard to height (P = 0.03). In both groups, ICW and ECW were maintained, although they were lower in the S-group compared to the non-S-group. SVV was maintained in both groups, although it was higher in the S-group than the non-S-group. HR was significantly lower in the S-group 1 h after induction of anesthesia (P < 0.003).
Changes in hemodynamics due to body fluid imbalance should be monitored during general anesthesia, especially for patients with special needs.
一些有特殊需求的患者存在智力残疾，包括认知技能缺陷和生活质量下降。本研究的目的是回顾性比较有特殊需求和无特殊需求患者在全身麻醉期间身体成分和血流动力学的变化。
从病历中记录接受全身麻醉下口腔颌面外科手术患者的背景信息。在麻醉开始后3小时记录细胞内液（ICW）、细胞外液（ECW）、每搏量变异度（SVV）和心率（HR）。分类数据采用不成对t检验进行比较，P值小于0.05被视为具有统计学意义。数值数据采用Bonferroni校正进行比较，P值小于0.0125被视为具有统计学意义。
本研究共纳入21例患者：10例无特殊需求患者（非S组）和11例有特殊需求患者（S组）。除身高外（P = 0.03），患者背景无显著差异。两组患者的ICW和ECW均得以维持，尽管S组低于非S组。两组患者的SVV均得以维持，尽管S组高于非S组。麻醉诱导后1小时，S组的HR显著降低（P < 0.003）。
全身麻醉期间应监测因体液失衡导致的血流动力学变化，尤其是有特殊需求的患者。
