Incidence, Risk Factors and Consequences of Emergence Agitation in Adult Patients after Elective Craniotomy for Brain Tumor: A Prospective Cohort Study.
Incidence, Risk Factors and Consequences of Emergence Agitation in Adult Patients after Elective Craniotomy for Brain Tumor: A Prospective Cohort Study.
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脑瘤的选颅切开术后成年患者出现搅动的发生率，危险因素和后果：一项前瞻性队列研究。
DOI：
10.1371/journal.pone.0114239
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Zhou JX
中科院分区：
文献类型：
--
作者：
Chen L;Xu M;Li GY;Cai WX;Zhou JX
苏醒期躁动是一种常见的并发症，可能会在全身麻醉恢复过程中产生严重后果。然而，对开颅手术后患者躁动的研究很少。在这项前瞻性队列研究中，成年患者因脑肿瘤择期开颅手术后入组。术后 12 小时内评估镇静-躁动量表。 123 名患者中有 35 名（29%）出现躁动。在烦躁的患者中，28 名 (80%) 被评为非常和危险的烦躁。通过多变量逐步逻辑回归分析，躁动的独立预测因素包括男性、长期使用抗抑郁药物或苯二氮卓类药物的病史、手术的额叶入路、麻醉方法和持续时间以及是否进行气管插管。全静脉麻醉和短时间平衡麻醉是保护因素。苏醒期躁动与自行拔管相关（8.6% vs 0%，P = 0.005）。躁动患者比非躁动患者更多地使用镇静剂（85.7% vs 6.8%，P<0.001）。总之，苏醒期躁动是脑肿瘤择期开颅手术后患者的常见并发症。明确危险因素有助于识别高危患者，进而有利于躁动的防治。对于开颅手术患者，应重点关注额入路开颅手术和平衡麻醉持续时间较长的患者。需要更多的研究来阐明全静脉麻醉是否可以减少开颅手术后躁动的发生率。 ClinicalTrials.gov NCT00590499。
Emergence agitation is a frequent complication that can have serious consequences during recovery from general anesthesia. However, agitation has been poorly investigated in patients after craniotomy. In this prospective cohort study, adult patients were enrolled after elective craniotomy for brain tumor. The sedation-agitation scale was evaluated during the first 12 hours after surgery. Agitation developed in 35 of 123 patients (29%). Of the agitated patients, 28 (80%) were graded as very and dangerously agitated. By multivariate stepwise logistic regression analysis, independent predictors for agitation included male sex, history of long-term use of anti-depressant drugs or benzodiazepines, frontal approach of the operation, method and duration of anesthesia and presence of endotracheal intubation. Total intravenous anesthesia and balanced anesthesia with short duration were protective factors. Emergence agitation was associated with self-extubation (8.6% vs 0%, P = 0.005). Sedatives were administered more in agitated patients than non-agitated patients (85.7% vs 6.8%, P<0.001). In conclusion, emergence agitation was a frequent complication in patients after elective craniotomy for brain tumors. The clarification of risk factors could help to identify the high-risk patients, and then to facilitate the prevention and treatment of agitation. For patients undergoing craniotomy, greater attention should be paid to those receiving a frontal approach for craniotomy and those anesthetized under balanced anesthesia with long duration. More researches are warranted to elucidate whether total intravenous anesthesia could reduce the incidence of agitation after craniotomy. ClinicalTrials.gov NCT00590499.
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影响因子：
4.1
作者：
Gottschalk, Allan;Berkow, Lauren C.;Yaster, Myron
通讯作者：
Yaster, Myron
影响因子：
9.8
作者：
Lepouse, C.;Lautner, C. A.;Leon, A.
通讯作者：
Leon, A.
DOI：
10.1007/bf03012507
发表时间：
1999-01-01
期刊：
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
影响因子：
--
作者：
Manninen, PH;Raman, SK;El-Beheiry, H
通讯作者：
El-Beheiry, H
影响因子：
8.8
作者：
Riker, RR;Picard, JT;Fraser, GL
通讯作者：
Fraser, GL
影响因子：
2.4
作者：
Senanarong, V;Cummings, JL;Strickland, TL
通讯作者：
Strickland, TL