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肝胆疾病手术患者麻醉苏醒期躁动危险因素分析
鲍杨1,2△,王振猛1△,史东平2,俞卫锋1*
0
(1.第二军医大学东方肝胆外科医院麻醉科,上海 200438;2.上海市嘉定区中心医院麻醉科,上海 201800)
摘要:
\[摘要\]目的探讨肝胆疾病患者麻醉苏醒期躁动的危险因素。方法选择肝胆疾病患者110余例,术后30 min内按镇静躁动分级法对其苏醒状况进行评分,排除4分以下的患者,对余下90例患者的相关病史资料分别作单因素及多因素Logistic回归分析,评价麻醉苏醒期躁动的相关因素。结果单因素分析发现:气道管理方式、麻醉维持方式、手术时间及吸附器的使用与躁动的发生显著相关(P值分别为:0.014、0.011、0.042、0.019)。多因素分析发现:麻醉诱导使用咪达唑仑、麻醉后导尿、全凭吸入麻醉等与躁动发生显著相关(P值分别为:0.026、0.049、0.004,OR值分别为:5.481、10.867、11.604)。结论肝胆疾病患者麻醉诱导给予咪达唑仑、麻醉后导尿、全凭吸入麻醉维持,术后躁动发生率显著增高。
关键词:  麻醉恢复期  苏醒期躁动  肝胆疾病  危险因素  Logistic模型
DOI:10.3724/SP.J.1008.2010.01333
投稿时间:2010-10-20修订日期:2010-11-15
基金项目:
Risk factor analysis of emergence agitation during anesthesia recovery period in 90 patients with hepatobiliary diseases
BAO Yang1,2△, WANG Zhen-meng1△, SHI Dong-ping2, YU Wei-feng1*
(1. Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China;2. Department of Anesthesiology, Jiading District Central Hospital, Shanghai 201800, China)
Abstract:
\[Abstract\]ObjectiveTo analyze the risk factors of emergence agitation in patients with hepatobiliary diseases. MethodsA total of 110 patients with hepatobiliary disease were enrolled in the present study. The level of emergence agitation was scored by sedation-agitation scale (SAS) 30 min after the surgery. Patients with SAS < 4, were excluded. Related medical data of the rest 90 patients were subjected to univariate and multivariate Logistic regression for analysis of risk factors of emergence agitation. ResultsUnivariate analysis revealed that the airway management method, anesthesia maintenance method, operation time and the use of anesthetic gas absorber were significantly correlated with the incidence of agitation (P values being 0.014, 0.011, 0.042 and 0.019, respectively). Multivariate analysis revealed that induction with midazolam, urinary catheterization after anesthesia and total inhalational anesthesia were significantly correlated with the incidence of agitation (P values being 0.026, 0.049 and 0.004, and the OR values being 5.481, 10.867, and 11.604, respectively). ConclusionIn patients with hepatobiliary diseases, induction with midazolam, total inhalational anaesthesia and urinary catheterization after anesthesia are associated with high incidence of emergence agitation following general anaesthesia.
Key words:  anesthesia recovery period  emergence agitation  hepatobiliary disease  risk factors  Logistic models