术后恢复质量量表分析全麻苏醒期躁动的预警指标  

Clinical research of postoperative quality of recovery scale for analysis of emergence agitation in patients with general anesthesia

作　　者：陈易[1] 俞一瑾[1] 倪新莉[1] 

机构地区：[1]宁夏医科大学总医院麻醉科,银川市750004

出　　处：《临床麻醉学杂志》2013年第8期782-784,共3页Journal of Clinical Anesthesiology

基　　金：宁夏回族自治区科技攻关计划宁陕合作项目(2012年)

摘　　要：目的采用术后恢复质量量表(PQRS)分析全麻苏醒期躁动(EA)的预警指标。方法选择择期全麻下行非心脑手术成年患者369例,应用PQRS于术前1d及拔管后15～40min(苏醒期)对患者生理功能、伤害性反应、情感变化、活动能力及认知功能等进行评估,对与EA相关指标进行单因素分析及Logistic多因素非条件回归分析。结果苏醒期出现躁动患者85例(23.04%)。多因素Logistic回归分析显示,EA危险度预警从高到低依次为术后意识恢复不良(OR3.99,95%CI2.06～7.77),术前焦虑(OR2.71,95%CI1.52～4.80),苏醒期气道不通畅(OR2.19,95%CI1.04～4.62),男性(OR2.02,95%CI1.15～3.57),苏醒期低氧(OR1.82,95%CI1.04～3.19),年龄小于45岁(OR1.68,95%CI1.16～2.44)以及术后疼痛(OR1.53,95%CI1.07～2.18)。结论应用PQRS分析,青年(<45岁)、男性、术前焦虑、术后意识恢复不良、气道不通畅、苏醒期低氧及术后疼痛是EA的重要预警指标。Objective To analyze the warning indicators of emergence agitation （EA） after general anesthesia with the use of postoperative quality of recovery scale （PQRS）. Methods A total of 369 patients undergoing non cardiac or brain surgery were enrolled. All subjects were assessed by PQRS on their physiological, nodceptive, emotional, activities of daily living and cognitive performance at day 1 before surgery and 15-40 rain （emergence period）after extubation. Univariate analysis was performed to those relative factors with EA, and sieved meaningful measures to carry on multivariate non conditional logistic regression analysis. Results Emergence agitation occurred in 85 patients with the incidence of 23. 04%. Logistic regression analysis results indicated that the risk factors of EA from high to low were poorer consciousness state （OR 3.99, 95%CI 2.06 7.77）, preoperative anxiety （OR 2.71,95% CI 1.52-4.80）, poorer airway maintenance （ OR 2.19, 95 % CI 1.04-4.62）, male gender（OR 2.02,95~CI 1.15-3.57）, hypoxemia （OR 1.82,95%CI 1.04-3.19）, less than 45 years of age （OR 1.68,95~CI 1.16-2.44） and nocioceptive pain （OR 1.53,95~CI 1.07- 2.18）. Conclusion Combined clinical comprehensive results of PQRS with statistical analysis to get a conclusion, young （~45 yr） male patients, preoperative anxiety, postoperative poorer consciousness state, poorer airway maintenance, hypoxia and nociceptive pain are important warning indicators of emergence agitation.

关 键 词：全身麻醉 苏醒期躁动 预警指标 

分 类 号：R614[医药卫生—麻醉学]