Chung F, Un V, Su J
Department of Anaesthesia, Toronto Western Division, Toronto Hospital, Ontario, Canada.
Can J Anaesth. 1996 Nov;43(11):1121-7. doi: 10.1007/BF03011838.
To test the hypothesis that the type of surgical procedure influences the incidence of postoperative symptoms. Also the effect of demographic and clinical risk variables: age, sex, ASA status, duration of anaesthesia on the postoperative symptoms were evaluated for each type of surgery.
Demographic, medical, anaesthetic and surgical data on 1,017 patients were prospectively collected by a research assistant who telephoned each patient 24 hr after discharge to administer a questionnaire to determine postoperative symptoms. Postoperative symptoms included incisional pain, nausea/vomiting, drowsiness, dizziness, headache and fever. In addition, 270 patients were asked the % (0-100) of their return to daily living function at 24 hr.
Incisional pain (26.9%), headache (11.6%), and drowsiness (11.5%) were the most frequently reported symptoms. Dizziness was reported by 9.7% and nausea/vomiting by 7.1%. Approximately 50% of patients undergoing laparoscopy, orthopaedic and general surgery reported 24-hr postoperative incisional pain. The incidence of 24-hr postoperative nausea/vomiting was highest after general 17.4%, orthopaedic, 11.2%, and laparoscopic surgery, 9.4%. Drowsiness was highest after laparoscopy 36.1%, followed by general surgery, 21.4%. Dizziness was most frequent after laparoscopy, 24.1%, followed by general surgery, 16.1%. After laparoscopy, postoperative drowsiness or dizziness was related to anaesthesia duration. After general surgery, postoperative dizziness or drowsiness were related to age; the younger the patient, the more likely the symptoms.
Postoperative pain, nausea/vomiting, drowsiness, dizziness, and headache were the more frequent postoperative symptoms 24 hr after ambulatory surgery and they were influenced by the type of surgical procedure. In addition, the type of surgery and the 24-hr postoperative symptoms determined the degree of return to daily living function.
检验手术方式会影响术后症状发生率这一假设。同时，针对每种手术类型，评估人口统计学和临床风险变量（年龄、性别、美国麻醉医师协会（ASA）分级、麻醉时长）对术后症状的影响。
一名研究助理前瞻性收集了1017例患者的人口统计学、医学、麻醉和手术数据，该助理在患者出院后24小时致电每位患者，发放问卷以确定术后症状。术后症状包括切口疼痛、恶心/呕吐、嗜睡、头晕、头痛和发热。此外，还询问了270例患者在24小时时恢复日常生活功能的百分比（0 - 100）。
最常报告的症状为切口疼痛（26.9%）、头痛（11.6%）和嗜睡（11.5%）。报告头晕的患者占9.7%，恶心/呕吐的患者占7.1%。接受腹腔镜手术、骨科手术和普通外科手术的患者中，约50%报告术后24小时有切口疼痛。术后24小时恶心/呕吐的发生率在普通外科手术后最高，为17.4%，骨科手术为11.2%，腹腔镜手术为9.4%。嗜睡发生率在腹腔镜手术后最高，为36.1%，其次是普通外科手术，为21.4%。头晕在腹腔镜手术后最常见，为24.1%，其次是普通外科手术，为16.1%。腹腔镜手术后，术后嗜睡或头晕与麻醉时长有关。普通外科手术后，术后头晕或嗜睡与年龄有关；患者越年轻，出现这些症状的可能性越大。
门诊手术后24小时，术后疼痛、恶心/呕吐、嗜睡、头晕和头痛是较常见的术后症状，且受手术方式影响。此外，手术类型和术后24小时症状决定了日常生活功能的恢复程度。
