>
网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
全麻术中知晓研究相关进展
作者:李静  刘丹彦 
单位:重庆医科大学附属第一医院 麻醉科, 重庆 400016
关键词:术中知晓 全身麻醉 高危因素 综述 
分类号:R614
出版年·卷·期(页码):2015·34·第六期(1029-1033)
摘要:

麻醉的原意是指感觉或知觉的丧失,后指用药物或其他方法使患者的中枢神经系统和(或)周围神经系统产生可逆性的功能抑制,使其在手术及有创操作时无疼痛和不适状态.而术中知晓却与麻醉的本意背道而驰,成为其重要并发症之一.术中知晓的发生率虽不高,但其对患者的影响极大,可带来不同程度精神损伤.通过评估患者高危因素可降低术中知晓发生率,麻醉深度的监测对其预防也有重要作用,但术中知晓的相关机制及预防仍需要进一步研究.作者就全麻术中知晓的研究进展作一综述.

参考文献:

[1] BRICE D D,HETHERINGTON R R,UTTING J E.A simple study of awareness and dreaming during anaesthesia[J].Br J Anaesth,1970,42:535-542.
[2] POLLARD R J,COYLE J P,GILBERT R L,et al.Intraoperative awareness in a regional medical system:a review of 3 years' data[J].Anesthesiology,2007,106:269-274.
[3] MASHOUR G A,WANG L Y,TURNER C R,et al.A retrospective study of intraoperative awareness with methodological implications[J].Anesth Analg,2009,108:521-526.
[4] MASHOUR G A,KENT C,PICTON P,et al.Assessment of intraoperative awareness with explicit recall:a comparison of 2 methods[J].Anesth Analg,2013,118:889-891.
[5] PANDIT J J,COOK T M,JONKER W R,et al.A national survey of anaesthetists (NAP5 Baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK[J].Anaesthesia,2013,68:343-353.
[6] PANDIT J J,ANDRADE J,BOGOD D G,et al.5th National Audit Project (NAP5) on accidental awareness during general anaesthesia:summary of main findings and risk factors[J].Br J Anaesth,2014,113:549-559.
[7] SANDIN R H,ENLUND G,SAMUELSSON P,et al.Awareness during anaesthesia:a prospective case study[J].Lancet,2000,355:707-711.
[8] SEBEL P S,BOWDLE T A,GHONEIM M M,et al.The incidence of awareness during anesthesia:a multicenter united states study[J].Anesth Analg,2004,99:833-839.
[9] MASHOUR G A,SHANKS A,TREMPER K K,et al.Prevention of intraoperative awareness with explicit recall in an unselected surgical population:a randomized comparative effectiveness trial[J].Anesthesiology,2012,117:717-725.
[10] XU L,WU A S,YUE Y.The incidence of intraoperative awareness during general anesthesia in China:a multi-center observational study[J].Anaesthesiologica Scandinavica,2009,53(7):873-882.
[11] 时昕,王东信.患者发生术中知晓的危险因素及预防措施[J].中华医学杂志,2013,93:3272-3275.
[12] 王锷,叶治,潘韫丹,等.全麻术中知晓的发生率以及相关危险因素[J].中南大学学报:医学版,2011,36:671-675.
[13] 王倩,王志发,郝在军,等.心血管手术患者术中知晓的发生情况[J].中华麻醉学杂志,2013,33:1407-1408.
[14] LESLIE K,CHAN M T,MYLES P S,et al.Posttraumatic stress disorder in aware patients from the B-aware trial[J].Anesth Analg,2010,110:823-828.
[15] OSTERMAN J E,HOPPER J,HERAN W J,et al.Awareness under anesthesia and the development of post traumatic stress disorder[J].Gen Hosp Psychiatry,2001,23:198-204.
[16] MORIMOTO Y,NOGAMI Y,HARADA K,et al.Awareness during anesthesia:the results of a questionnaire survey in Japan[J].J Anesth,2011,25(1):72-77.
[17] HOYMORK S C,RAEDER J.Why do women wake up faster than men from propofol anaesthesia[J].Br J Anaesth,2005,95(5):627-633.
[18] DAVIDSON A J,SMITH K R,BLUSSE van OUD-ALBLAS H J,et al.Awareness in children:a secondary analysis of five cohort studies[J].Anaesthesia,2011,66 (6):446-454.
[19] BLUSSE van OUD-ALBLAS H J,van DIJK M,LIU C,et al.Intraoperative awareness during paediatric anaesthesia[J].Br J Anaesth,2009,102 (1):104-110.
[20] ARANAKE A,GRADWOHL S,BEN-ABDLLAH A,et al.Increased risk of intraoperative awareness in patients with a history of awareness[J].Anesthesiology,2013,119:1275-1283.
[21] RADOVANOVIC Z.Awareness during general anaesthesia-implications of explicit intraoperative recall[J].Eur Rev Med Pharmacol Sci,2011,15(9):1085-1089.
[22] KRETSCHMANNOVA K,HINES R M,REVILLA-SANCHEZ R,et al.Enhanced tonic inhibition influences the hypnotic and amnestic actions of the intravenous anesthetics etomidate and propofol[J].J Neurosci,2013,33:7264-7273.
[23] OSBORNE G A,BACON A K,RUNCIMAN W B.Crisis management during anaesthesia:awareness and anaesthesia[J].Qual Saf Health Care,2005,14(3):16-21.
[24] MYLES P S,LESLIE K,MCNEIL J,et al.Bispectral index monitoring to prevent awareness during anaesthesia:the B-Aware randomised controlled trial[J].Lancet,2004,363:1757-1763.
[25] ROBINS K,LYONS G.Intraoperativa awareness during general anesthesia for cesarean delivery[J].Anesth Analg,2009,109(3):886-890.
[26] ERRANDO C L,SIGL J C,ROBLES M,et al.Awareness with recall during general anaesthesia:a prospective observational evaluation of 4001 patients[J].Br J Anaesth,2008,101(2):178-185.
[27] EKMAN A,LINDHOLM M L,LENNMARKEN C,et al.Reduction in the incidence of awareness using bispectral index monitoring[J].Acta Anaesthesiol Scand,2004,48:20-26.
[28] PUNJASAWADWONG Y,BOONJEUNGMONKOL N,PHONGCHIEWBOON A.Bispectral index for improving anaesthetic delivery and postoperative recovery[J].Cochrane Database Syst Rev,2007 (Updated 2010):CD003843.
[29] AVIDAN M S,JACOBSOHN E,GLICK D,et al.Prevention of intraoperative awareness in a high-risk surgical population[J].N Engl J Med,2011,365:591-600.
[30] MASHOUR G A,TREMPER K K,AVIDAN M.Protocol for the "Michigan Awareness Control Study":a prospective,randomized,controlled trial comparing electronic alerts based on bispectral index monitoring or minimum alveolar concentration for the prevention of intraoperative awareness[J].BMC Anesthesiol,2009,9:7.
[31] RADTHK F M,FRANCK M,LENDNER J,et a1.Monitoring depth of anaesthesia in a randomized trial decreases the rate of postoperative delirium but not postoperative cognitive dysfunction[J].Br J Anaesth,2013,110 :98-105.
[32] 杨晓辉.脑电双频指数在老年患者腹部手术全身麻醉中的应用评价[J].现代医学,2014,42(1):1336-1338.
[33] 许先成,孙艳玲,吴五洲,等.BIS监测在小儿室间隔缺损介入术麻醉中的应用[J].现代医学,2010,38 (6):612-615.
[34] DUTTON R C,MAURER A J,SONNER J M,et al.The concentration of isoflurane required to suppress learning depends on the type of learning[J].Anesthesiology,2001,94(3):514-519.
[35] THIELE R H,KNIPPER E,DUNN L K,et al.Auditory stimuli as a contributor to consciousness while under general anesthesia[J].Med Hypotheses,2013,80:568-572.
[36] THARAHIRUNCHOT S,TATIYAPONGPINIJ S,UERPAIROJKIT K.Effect of noise block using earplugs on propofol sedation requirement during extracorporeal shock wave lithotripsy[J].J Med Assoc Thai,2011,94:103-107.
[37] AEAN A,MOLLER K.Through and beyond anaesthesia awareness[J].Br Med J,2010,341:830-831.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 418347 位访问者


copyright ©《东南大学学报(医学版)》编辑部
联系电话:025-83272481 83272483
电子邮件:
bjb@pub.seu.edu.cn

苏ICP备09058364