国际麻醉学与复苏杂志   2019, Issue (6): 0-0
    
下肢骨创伤患者麻醉后监测治疗室滞留时间相关因素分析
张荦, 孙建宏, 张建友, 张转, 杨成亮, 邢智1()
1.扬州大学附属医院
An unconditional logistic regression analysis of factors of prolonged post-anesthesia care unit duration for lower limbs trauma surgery patients
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摘要:

目的 分析全身麻醉下肢骨创伤手术患者在PACU滞留时间延长的相关因素。 方法 2014年至2017年行骨创伤手术并符合条件的 442 例患者。根据麻醉及复苏记录,收集患者的年龄、性别、Hb、手术方式、出血量、麻醉方式等24项资料,筛选差异有统计学意义的因素,再进行Logistic多因素回归分析。 结果 年龄、术前贫血状态、肺功能情况、肾功能情况、ASA分级、右美托咪定(dexmedetomidine, Dex)的使用、术中舒芬太尼用量、是否复合吸入麻醉、是否复合腰丛-坐骨神经阻滞麻醉、术毕尿量、术毕体温、术中出血量、术中输液量以及术中是否输血等因素与患者PACU滞留时间有相关性。多因素分析后显示年龄>65岁、Hb<100 g/L、一秒用力呼气量<60%、高ASA分级和低体温患者术后PACU滞留时间明显延长(P<0.05);使用Dex、复合腰丛-坐骨神经阻滞和正常尿量患者在PACU滞留的时间较短(P<0.05)。 结论 年龄、Hb水平、肺功能情况、ASA分级、Dex的使用、是否复合腰丛-坐骨神经阻滞、术毕尿量、术毕体温和术中输液量等因素与下肢骨创伤手术患者术后PACU滞留的时间长短有相关性。

关键词: 骨科手术; 麻醉后监测治疗室; 延迟
Abstract:

Objective To study the relative factors which influence the post-anesthesia care unit (PACU) stay of the patients underwent the lower limb orthopedic surgery. Methods A total of 442 patients who underwent orthopedic surgery from 2014 to 2017 were investigated. According to the patients′ anesthesia and recovery records, the age, sex, hemoglobin(Hb), surgical procedures, bleeding volume and anesthetic methods, etc. were collected. The possible variables that lead to the discharge delay from PACU were assigned for the regression analysis. The Logistic regression analysis was used in the analysis of the related factors of the delay in PACU. Results The age, anemia, pulmonary function, kidney function, American Society of Anesthesiologists(ASA) level, use of dexmedetomidine (Dex), the consumption of fentanyl, inhalation anesthetics, lumbar-sciatic nerve block, urine volume, hypothermia, bleeding volume, infusion volume and transfusion volume had effects on the delay in PACU. Multivariate analysis showed that the age>65 years, Hb<100 g/L, forced expiratory volume in one second (FEV1)<60%, high ASA grade and hypothermia can prolong the duration of PACU stay after operation. The use of Dex, lumbar-sciatic plexus block, urine volume can shorten the time in PACU. Conclusions Age, Hb level, lung function, ASA level, the use of Dex, lumbar-sciatic plexus block, urine volume, body temperature and transfusion volume were related to the duration in PACU in patients with orthopedic trauma surgery.

Key words: Orthopedic surgery; Post-anesthesia care unit; Delay