全麻术中知晓的发生率以及相关危险因素

摘要

Objective To investigate the incidence of awareness during general anesthesia and analyze the risk factors in anesthetic practice and patient populations.Methods A total of 2 300 patients who underwent general anesthesia were included.Perioperative data and anesthetic drugs were collected prospectively.Patients were interviewed twice postoperatively with the same structured questionnaire.Each patient was classified into categories as no awareness, possible awareness, and awareness.Results Twenty-one patients (0.91％ ) definitely reported awareness,and another 205 (8.91％ ) reported possible awareness.Few of the patients with awareness required psychological intervention.ASA physical status Ⅲ-Ⅳ and propofol maintenance were associated risk factors of awareness.Conclusion The incidence of intraoperative awareness is high in the clinical practice in major medical centers.%目的:探究减少术中知晓发生率的途径,调查全麻术中知晓的发生率,并分析相关危险因素.方法:收集2 300例行全身麻醉的外科手术患者围手术期一般资料和麻醉药物用法用量,术后2次用标准化询问方式调查术中知晓的发生情况.所有患者分为3组:无知晓、可疑知晓和术中知晓.结果:肯定术中知晓的有21例(0.91%),术中可疑知晓的患者有205例(8.91%).美国麻醉师协会(ASA)分级III～IV级和丙泊酚维持麻醉是术中知晓的相关危险因素.结论:目前国内大型综合性医院的临床麻醉中术中知晓的发生率仍然较高,应当引起重视.