摘要
目的:调查重庆医科大学附属第一医院全身麻醉手术术中知晓发生率,并分析其发生的高危因素。方法:选择重庆医科大学附属第一医院2015年3至12月全身麻醉患者共5 816例。采用改良布莱斯量表分别于术后第1天、第3天对患者进行询问:1)在入睡之前你记得的最后一件事是什么?2)在你醒来后记得的第一件事是什么?3)这两者之间你还记得什么?4)手术过程中你做过梦吗?5)关于这次手术你感觉最差的是什么?分别由两名专业人员对随访结果参照Sandin等所使用的方法对患者进行评估,判断为术中知晓组、可疑知晓组及无知晓组。结果:在随访的5 816例患者中,有15例(0.26%)发生了术中知晓,4例(0.07%)为可疑知晓,40例(0.69%)患者诉有做梦现象。对术中知晓相关因素采用logistic回归分析,既往手术麻醉史为术中知晓高危因素。结论:既往手术麻醉史为术中知晓高危因素;术前使用咪唑为术中知晓的保护因素。产科手术、腹腔镜手术、全凭静脉麻醉术中知晓发生率较高。
Objective： To investigate the incidence of accidental awareness during general anesthesia in The First Affiliated Hospital of Chongqing Medical University and analyze the risk factors of accidental awareness. Methods： A total of 5 816 patients who received general anesthesia were enrolled in between March 2015 to December in The First Affiliated Hospital of Chongqing Medical University. Patients were interviewed with improved Brice questionnaire survey at the first and the third day after operation. The improved Brice questionnaire were： 1） What is the last thing you remember before going to sleep？ 2） What is the first thing you remember when waking up？ 3） Do you remember anything between going to sleep and waking up？ 4） Did you dream during your procedure？ 5） What was the worst thing about your operation？ Patients were classified into awareness, possible awareness and no awareness according to the method used by Sandin. The logistic regression analysis were used to analyze the risk factors. Results： The results indicated that fifteen cases（0.26%） were reported as awareness and four cases（0.07%） as possible awareness. Forty patients（0.69%） had dreams during general anesthesia. Awareness was associated with a previous anesthesia. Using midazolam might prevent awareness during operation. Conclusion： Awareness was associated with a previous anesthesia. There were higher incidence in obstetric surgery, laparoscopic surgery, and anesthesia methods of total intravenous anesthesia.
出处
《临床与病理杂志》
2017年第6期1158-1163,共6页
Journal of Clinical and Pathological Research
基金
卫生部国家临床重点专科建设项目[财设(2011)170]
重庆市重点学科项目[渝卫科教(2007)2]~~
关键词
术中知晓
全身麻醉
高危因素
accidental awareness
general anesthesia
risk factors
