妇科腹腔镜手术全身浅麻醉术中患者知晓率调查及其影响因素分析

目的调查在全身浅麻醉下行妇科附件良性肿瘤腹腔镜手术中患者的知晓率并分析其影响因素。方法随机选择900例在全身浅麻醉下行腹腔镜手术的妇科附件良性肿瘤患者，术后第1天及第2天调查患者有无术中知晓情况并统计知晓率，采用多元Logistic回归对相关影响因素进行分析。结果900例中有11例发生术中知晓，知晓率为1．22％。术中知晓的发生与年龄、术中低血压、过早停药、急诊手术等因素有关。结论妇科附件良性肿瘤腹腔镜手术全身浅麻醉知晓与年龄、术中低血压、过早停药、急诊手术等因素有关。预防术中知晓的根本措施在于合理监测麻醉深度。

Investigation of awareness during general light anesthesia in patients undergoing gynecologic laparoscopic surgery and analysis of its influencing factors

Objective To investigate the incidence of awareness during general light anesthesia in patients undergoing gynecologic laparoscopie surgery and analyze the risk factors of awareness in operation. Methods A total of 900 patients with benign adnexal neoplasm undergoing laparoscopic surgery under general light anesthesia were surveyed by questionnaire on the first and second day after surgery, and the incidence of awareness during operation was eounted. The sensory perception was recorded in patients having awareness in operation. The factors that probably in- fluenced awareness were analyzed with the method of multiple regression analysis. Results Eleven patients （ 1.22% ） were identified as awareness. Incidence of awareness was associated with age, circulating state of the patients, premature withdrawal and emergency surgery, did not relate with weight. Conclusion The high risk factors of intraoperative awareness are associated with age, circulating state of the patients, premature withdrawal and emergency surgery. Reasonable depth of anesthesia monitoring is a fundamental measure to prevent intraoperative awareness.