Tamire Tadese, Demelash Habtamu, Yetneberk Tikuneh, Kibret Simegnew
College of Health Sciences, Department of Anaesthesia, Debre Tabor University, Debra Tabor, Ethiopia.
College of Health Sciences, Department of Public Health, Debre Tabor University, Debra Tabor, Ethiopia.
Anesthesiol Res Pract. 2019 Jul 7;2019:7043279. doi: 10.1155/2019/7043279. eCollection 2019.
Awareness with recall of intraoperative events is an infrequent but potentially devastating complication of general anesthesia, with a reported incidence of 0.1-0.2% in low-risk patients. Higher incidence is expected in resource-limited operation room setups and in high-risk patients. Awareness can result in significant distress to patients and long-term psychological consequences, including symptoms associated with posttraumatic stress disorder, anxiety, night mares, night terror, dissatisfaction with surgical service, and sometimes even suicide.
To assess the magnitude and associated factors of awareness with recall under general anesthesia in Amhara regional state referral hospitals.
An institution-based cross-sectional study was conducted on 1065 patients who underwent surgery under general anesthesia from January 1 to June 30, 2018. The study participants were selected by systematic random sampling from 4 referral hospitals. The modified Brice questionnaire was used to detect awareness under general anesthesia. Interviewer-administered structured questionnaire and chart review were employed. Data with complete information were entered in to SPSS version 20 computer software. Descriptive statics and bivariate and multivariable analysis were computed. A -value less than 0.2 was used to select candidate variables for multivariable logistic regression. A -value less than 0.05 was used to declare statistical significance.
1065 patients were included in the study which makes the response rate of 90.7%. The magnitude of awareness with recall under general anesthesia was found to be 8.2% of which 4.9%, 2.6%, and 0.7% of patients reported hearing voice, pain, and sensation of breathing tube, respectively. Lack of premedication was the only significantly associated factor for awareness with recall under general anesthesia (AOR = 3.014, 95% CI (1.201 to 7.565)).
Our study showed higher magnitude of awareness with recall under general anesthesia. Lack of premedication was the only associated factor with awareness with recall under general anesthesia. Anesthetists should give emphasis to prevent the possibility of awareness under general anesthesia by providing premedication. Cohort studies should be done including the consequences of awareness with recall under general anesthesia.
术中知晓并能回忆手术过程是全身麻醉中一种少见但可能具有毁灭性的并发症，据报道，低风险患者的发生率为0.1%-0.2%。在资源有限的手术室环境和高风险患者中，发生率预计会更高。术中知晓会给患者带来极大痛苦，并产生长期的心理后果，包括与创伤后应激障碍、焦虑、噩梦、夜惊、对手术服务不满意相关的症状，有时甚至会导致自杀。
评估阿姆哈拉地区转诊医院全身麻醉下术中知晓并能回忆的程度及相关因素。
对2018年1月1日至6月30日期间接受全身麻醉手术的1065例患者进行了一项基于机构的横断面研究。研究参与者通过系统随机抽样从4家转诊医院中选取。采用改良的布赖斯问卷来检测全身麻醉下的术中知晓情况。采用访谈者实施的结构化问卷和病历审查。将具有完整信息的数据录入SPSS 20版计算机软件。计算描述性统计量以及双变量和多变量分析。A值小于0.2用于选择多变量逻辑回归的候选变量。A值小于0.05用于判定具有统计学意义。
1065例患者纳入本研究，应答率为90.7%。全身麻醉下术中知晓并能回忆的程度为8.2%，其中分别有4.9%、2.6%和0.7%的患者报告听到声音、感到疼痛和有气管插管的感觉。未进行术前用药是全身麻醉下术中知晓并能回忆的唯一显著相关因素（比值比=3.014，95%置信区间（1.201至7.565））。
我们的研究显示全身麻醉下术中知晓并能回忆的程度较高。未进行术前用药是全身麻醉下术中知晓并能回忆的唯一相关因素。麻醉医生应重视通过给予术前用药来预防全身麻醉下术中知晓的可能性。应开展队列研究，包括全身麻醉下术中知晓并能回忆的后果。
