苏醒期躁动(EA)是全麻苏醒期的临床常见并发症之一,主要表现为定向功能和感知功能改变的、对自身环境的认知和关注能力的障碍。EA的整体发生率因各因素影响从0.25%到90.5%不等,如处理不当,可对患者自身和医护人员造成严重危害。而早期目标导向镇静(EGDS)理念有助于减弱或消除伤害性刺激诱发的不良后果,从而减少EA的发生率,使全麻患者的复苏过程更加平稳舒适。本文围绕EA的影响因素、危害,以及EGDS理念的优势、常用药物等方面展开论述,为改善全麻患者的复苏质量,减少EA的发生率提供参考。Emergence agitation (EA) is one of the common complications during the recovery period after general anesthesia, primarily characterized by alterations in orientation and perceptual functions, leading to impaired cognitive and attentional abilities regarding one’s environment. The overall incidence of EA varies widely from 0.25% to 90.5% depending on various factors, and if not managed properly, it can pose serious risks to both patients and healthcare personnel. The concept of early goal-directed sedation (EGDS) can help mitigate or eliminate the adverse effects induced by harmful stimuli, thereby reducing the incidence of EA and making the recovery process for patients undergoing general anesthesia smoother and more comfortable. This article discusses the influencing factors and hazards of EA, as well as the advantages of the EGDS approach and commonly used medications, providing a reference for improving recovery quality in patients undergoing general anesthesia and reducing the incidence of EA.
目的探讨围术期护理干预对腹腔镜手术患者全身麻醉苏醒期躁动的影响。方法选取2023年1月—7月医院收治的行全身麻醉腹腔镜手术患者164例为研究对象,分为对照组(n=82)和研究组(n=82)。对照组采用常规围手术期护理干预,研究组在对照组基础上采用预见性护理干预措施。对比两组术后15 min RASS镇静评分、苏醒时间、苏醒期躁动发生率、苏醒期生命体征和术后恢复相关指标。结果研究组患者术后15 min RASS评分低于对照组(P<0.05)。研究组苏醒期躁动发生率低于对照组,差异有统计学意义(P<0.05)。麻醉苏醒期,研究组收缩压(SBP)、舒张压(DBP)、心率(HR)升高幅度较对照组小,体温(T)降低幅度较对照组小,差异有统计学意义(P<0.01)。与对照组相比,研究组麻醉苏醒时间、自主呼吸恢复时间和拔管时间缩短,差异有统计学意义(P<0.01)。结论围手术期预见性护理干预措施可缩短腹腔镜手术患者全身麻醉苏醒时间,降低苏醒期躁动发生率,维持生命体征平稳。
目的研究手术室麻醉苏醒期躁动患者应用优质护理的效果及对患者睡眠质量的影响。方法以随机数表法将2022年1—12月南京市高淳人民医院收治的80例手术室麻醉苏醒期躁动患者分为对照组和实验组,各40例。对照组行常规护理,实验组在常规护理基础上行优质护理,比较2组护理效果。结果干预后,实验组睡眠质量[匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)]评分、心理状态[简式心境状态量表(profile of mood state,POMS)]评分低于对照组,实验组健康状况[简明健康调查量表(the MOS item short from health survey,SF-36)]评分及护理满意率高于对照组,差异均有统计学意义(P<0.05)。结论手术室麻醉苏醒期躁动患者行优质护理可有效缓解患者负性情绪,改善患者睡眠质量与健康状况,提高护理满意度。
