麻醉期间的意识:一个前性的案例研究
R H Sandin1, G Enlund, P Samuelsson
1Department of Anaesthesia and Intensive Care, Länssjukhuset, Kalmar, Sweden. rolfs@ltkalmar.se
Lancet (London, England)
|March 7, 2000
概括
一般麻醉意识影响0.18%的患者,大多数病例是通过后来的采访检测出来的. 目前的保护措施不足,这表明需要神经生理学监测,以防止患者的痛苦.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
背景情况:
- 一般麻醉并不能保证在手术期间失去意识.
- 关于保护措施的知识和患者对意识的反应是有限的.
研究的目的:
- 为了评估在全身麻醉期间的意识意识.
- 评估当前保护措施的有效性.
主要方法:
- 一项前性案例研究,涉及11,785名接受全身麻醉的患者.
- 患者在三个时间点接受了意识采访:麻醉后护理单位,1-3天和手术后7-14天.
主要成果:
- 确定了18例意识病例和1例无意的肌肉阻塞.
- 意识的发生率是0.18%与神经肌肉阻断药物和0.10%没有.
- 面试延迟显著增加了意识检测;在最后的面试中发现了17/18例.
- 与接受肌肉松剂的患者相比,非患者的不良心理结果较少.
结论:
- 传统措施不足以防止麻醉意识.
- 建议对大脑活动进行神经生理监测,但其灵敏度尚不清楚.
- 至少有861名患者需要监测,以防止在放松麻醉期间遭受意识损伤的一例.
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