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2022年全身麻醉术后延迟苏醒及其相关因素:一项横断面研究

Delayed awakening and its associated factor following general anesthesia service, 2022: a cross-sectional study.

作者信息

Bayable Samuel D, Amberbir Wubet D, Fetene Melaku B

机构信息

Department of Anesthesia, College of Medicine and Health Science, Debre Markos University, Amhara.

Department of Anesthesia, Menelik II Health Science College, Addis Abeba.

出版信息

Ann Med Surg (Lond). 2023 Jul 31;85(9):4321-4328. doi: 10.1097/MS9.0000000000001103. eCollection 2023 Sep.

Abstract

BACKGROUND

The time to emerge from anesthesia is affected by patient factors, anesthetic factors, the duration of surgery, and preoperative and intraoperative pain management.

OBJECTIVE

This study aimed to determine the prevalence and contributing factors of delayed awakening following general anesthesia.

METHOD

A cross-sectional study was conducted from January to June 2022. After getting ethical approval with the permission number S/C/R 37/01/2022, willing patients participate with written informed consent. Chart reviews in the preoperative and postoperative recovery rooms were used to collect data. Frequency and percentage with cross-tabulation were used to provide the descriptive statistics. To determine the predictive variables that were associated with the outcome variable, bivariable, and multivariable logistic regression models were fitted. The statistical significance was evaluated using -values of 0.05 for multivariable regression.

RESULTS

In the current study, a normal emergency occurred in 91.7% of surgical patients receiving general anesthesia, while delayed awakening, emergence with hypoactive, and emergence with delirium occurred in 2.6, 3.9, and 1.8% of cases, respectively. Patients older than 64 years [adjusted odds ratio (AOR): 1.33, 95% CI: 0.83-7.191], being diploma anesthesia providers (AOR: 2.38, 95% CI: 2.05-7.15), opioids (AOR: 2.3, 95% CI: 2.20-5.76), surgery lasting longer than 2 h (AOR: 1.91, 95% CI: 1.83-6.14), estimated blood loss of more than 1500 ml (AOR: 1.20, 95% CI: 0.62-11.30), crystalloid administration of more than 3000 ml (AOR: 3.12, 95% CI: 2.19-7.32), intraoperative hypotension (AOR: 3.37, 95% CI: 2.93-9.41) and extreme body weight, were significantly linked to delayed awakening after general anesthesia.

CONCLUSION

Although delayed emergence is an uncommon condition with a number of contributing causes, it is preventable, and once it has occurred, it presents a challenge for anesthetists.

摘要

背景

从麻醉中苏醒的时间受患者因素、麻醉因素、手术时长以及术前和术中疼痛管理的影响。

目的

本研究旨在确定全身麻醉后苏醒延迟的发生率及相关因素。

方法

于2022年1月至6月进行了一项横断面研究。在获得伦理批准(批准号S/C/R 37/01/2022)后,自愿患者签署书面知情同意书参与研究。通过术前和术后恢复室的病历回顾来收集数据。使用交叉表的频率和百分比进行描述性统计。为确定与结果变量相关的预测变量,拟合了双变量和多变量逻辑回归模型。多变量回归采用P值0.05评估统计学意义。

结果

在本研究中,91.7%接受全身麻醉的手术患者正常苏醒,而苏醒延迟、苏醒时活动减退和苏醒时谵妄的发生率分别为2.6%、3.9%和1.8%。64岁以上患者[调整优势比(AOR):1.33,95%置信区间(CI):0.83 - 7.191]、麻醉文凭提供者(AOR:2.38,95% CI:2.05 - 7.15)、使用阿片类药物(AOR:2.3,95% CI:2.20 - 5.76)、手术持续时间超过2小时(AOR:1.91,95% CI:1.83 - 6.14)、估计失血量超过1500毫升(AOR:1.20,95% CI:0.62 - 11.30)、晶体液输注量超过3000毫升(AOR:3.12,95% CI:2.19 - 7.32)、术中低血压(AOR:3.37,95% CI:2.93 - 9.41)以及极端体重,均与全身麻醉后苏醒延迟显著相关。

结论

尽管苏醒延迟是一种由多种原因导致的不常见情况,但它是可预防的,一旦发生,会给麻醉医生带来挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b34e/10473332/5696c7c54617/ms9-85-4321-g001.jpg

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