摘要
目的探讨术前焦虑对全麻下行髋关节置换的老年患者术中低体温、出血量及苏醒质量的影响。方法选择2019年2月~2022年2月于南京医科大学附属宿迁市第一人民医院手术室行单侧髋关节置换的169例老年患者作为研究对象,根据阿姆斯特丹术前焦虑及信息需求量表(APAIS)评分进行分组,APAIS评分<12分为对照组(114例),APAIS评分≥12分为焦虑组(55例)。对两组术中低体温、出血量、术后感染情况、苏醒质量及术中麻醉及镇痛药物用量进行比较。结果焦虑组在麻醉60 min和麻醉结束时的体温低于对照组,术中低体温及术中出血量>400 mL的发生率均高于对照组,麻醉恢复室停留时间长于对照组,苏醒延迟、寒战及吸空气脉搏血氧饱和度<90%的发生率均高于对照组,差异均有统计学意义(P<0.05)。两组在麻醉诱导后即刻、麻醉30 min的体温,切口感染、恶心呕吐发生率及术中麻醉维持用药剂量比较,差异均无统计学意义(P>0.05)。结论术前合并焦虑的全麻下行髋关节置换的老年患者,术中1 h开始体温出现更为明显的下降,术中低体温发生率更高,术中出血量更多,苏醒质量较差,苏醒期不良反应发生率更高,应引起关注。
Objective To investigate the effect of preoperative anxiety on intraoperative hypothermia,blood loss and recovery quality in elderly patients undergoing hip replacement under general anesthesia.Methods A total of 169 elderly patients who received unilateral hip arthroplasty in the operating room of Suqian First People's Hospital Affiliated to Nanjing Medical University from February 2019 to February 2022 were selected as the study subjects and divided into the control group(n=114)with APAIS score12 and the anxiety group(n=55)with APAIS score≥12 according to the Amsterdam Preoperative Anxiety and Information Requirements Scale(APAIS)score.Intraoperative hypothermia,blood loss,postoperative infection,recovery quality and intraoperative anesthetic and analgesic drug dosage were compared between the two groups.Results The body temperature at 60 min of anesthesia and at the end of anesthesia was lower in the anxious group than in the control group.The incidence of intraoperative hypothermia and intraoperative blood loss400 mL was higher than that in the control group.The stay time in the anesthesia recovery room was longer than that in the control group.The incidence of delayed recovery,chills and air aspiration pulse saturation90%was higher than that in the control group.The differences were statistically significant(P0.05).There was no significant difference in body temperature,incidence of incision infection,nausea and vomiting,and intraopenative anesthesia maintenance dosage between the two groups immediately after anesthesia induction and 30 min after anesthesia between the two groups(P0.05).Conclusion Elderly patients undergoing hip arthroplasty under general anesthesia with preoperative anxiety have a more significant decrease in body temperature 1 h after operation,the incidence of intraoperative hypothermia,more intraoperative blood loss,poor quality of recovery,and the incidence of adverse reactions during recovery,which should be concerned.
作者
陈悦
吴磊
叶青青
吴浩
戴体俊
Chen Yue;Wu Lei;Ye Qingqing;Wu Hao;Dai Tijun(Department of Anesthesiology,Suqian First People′s Hospital Affiliated to Nanjing Medical University,Suqian 223800;Department of Anesthesia Pharmacology,Xuzhou Medical University,Xuzhou 22100)
出处
《国际老年医学杂志》
2023年第6期701-704,共4页
International Journal of Geriatrics
基金
国家自然科学基金项目(30872432)
江苏省妇幼健康科研项目(F201753)。
关键词
术前焦虑
髋关节置换
体温
苏醒质量
Preoperative anxiety
Hip replacement
Body temperature
Quality of recovery
