PDF(Pubmed)
Abstract：
BACKGROUND: Post-anesthetic emergence agitation is common after general anesthesia and may cause adverse consequences, such as injury as well as respiratory and circulatory complications. Emergence agitation after general anesthesia occurs more frequently in nasal surgery than in other surgical procedures. This study aimed to assess the occurrence of emergence agitation in patients undergoing nasal surgery who were extubated under deep anesthesia or when fully awake.
METHODS: A total of 202 patients (18-60 years, American Society of Anesthesiologists classification: I-II) undergoing nasal surgery under general anesthesia were randomized 1:1 into two groups: a deep extubation group (group D) and an awake extubation group (group A). The primary outcome was the incidence of emergence agitation. The secondary outcomes included number of emergence agitations, sedation score, vital signs, and incidence of adverse events.
RESULTS: The incidence of emergence agitation was lower in group D than in group A (34.7% vs. 72.8%; p < 0.001). Compared to group A, patients in group D had lower Richmond Agitation-Sedation Scale scores, higher Ramsay sedation scores, fewer agitation episodes, and lower mean arterial pressure when extubated and 30 min after surgery, whereas these indicators did not differ 90 min after surgery. There was no difference in the incidence of adverse events between the two groups.
CONCLUSIONS: Extubation under deep anesthesia can significantly reduce emergence agitation after nasal surgery under general anesthesia without increasing the incidence of adverse events.
BACKGROUND: Registered in Clinicaltrials.gov (NCT04844333) on 14/04/2021.
METHODS: A total of 202 patients (18-60 years, American Society of Anesthesiologists classification: I-II) undergoing nasal surgery under general anesthesia were randomized 1:1 into two groups: a deep extubation group (group D) and an awake extubation group (group A). The primary outcome was the incidence of emergence agitation. The secondary outcomes included number of emergence agitations, sedation score, vital signs, and incidence of adverse events.
RESULTS: The incidence of emergence agitation was lower in group D than in group A (34.7% vs. 72.8%; p < 0.001). Compared to group A, patients in group D had lower Richmond Agitation-Sedation Scale scores, higher Ramsay sedation scores, fewer agitation episodes, and lower mean arterial pressure when extubated and 30 min after surgery, whereas these indicators did not differ 90 min after surgery. There was no difference in the incidence of adverse events between the two groups.
CONCLUSIONS: Extubation under deep anesthesia can significantly reduce emergence agitation after nasal surgery under general anesthesia without increasing the incidence of adverse events.
BACKGROUND: Registered in Clinicaltrials.gov (NCT04844333) on 14/04/2021.
摘要：
背景：全身麻醉后出现躁动很常见，可能会导致不良后果，如损伤以及呼吸和循环并发症。全身麻醉后出现的躁动在鼻手术中比在其他外科手术中更常见。这项研究旨在评估在深度麻醉下或完全清醒时接受鼻手术的患者出现躁动的发生。
方法：共202名患者（18-60岁，美国麻醉医师协会分类：I-II）在全身麻醉下进行鼻手术，随机分为两组：深拔管组（D组）和清醒拔管组（A组）。主要结果是出现躁动的发生率。次要结果包括出现波动的数量，镇静评分,生命体征,和不良事件的发生率。
结果：D组苏醒期躁动发生率低于A组（34.7%vs.72.8%；p<0.001)。与A组相比,D组患者的里士满激动镇静量表评分较低，更高的Ramsay镇静评分,更少的激动发作，拔管时和手术后30分钟的平均动脉压降低，而这些指标在手术后90分钟没有差异。两组不良事件发生率无差异。
结论：深度麻醉下拔管可显著减少全麻鼻部手术后苏醒期躁动，且不增加不良事件的发生率。
背景：于2021年4月14日在Clinicaltrials.gov（NCT04844333）注册。
方法：共202名患者（18-60岁，美国麻醉医师协会分类：I-II）在全身麻醉下进行鼻手术，随机分为两组：深拔管组（D组）和清醒拔管组（A组）。主要结果是出现躁动的发生率。次要结果包括出现波动的数量，镇静评分,生命体征,和不良事件的发生率。
结果：D组苏醒期躁动发生率低于A组（34.7%vs.72.8%；p<0.001)。与A组相比,D组患者的里士满激动镇静量表评分较低，更高的Ramsay镇静评分,更少的激动发作，拔管时和手术后30分钟的平均动脉压降低，而这些指标在手术后90分钟没有差异。两组不良事件发生率无差异。
结论：深度麻醉下拔管可显著减少全麻鼻部手术后苏醒期躁动，且不增加不良事件的发生率。
背景：于2021年4月14日在Clinicaltrials.gov（NCT04844333）注册。
