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Analysis of influencing factors of secondary delirium after laparoscopic surgery
Xu Yi, Zhu Guochao, Chen Jing, Li Ruixue, Liao Tie, Zeng Ye
Journal of Abdominal Surgery ›› 2019, Vol. 32 ›› Issue (5) : 376-380,390.
PDF(748 KB)
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Analysis of influencing factors of secondary delirium after laparoscopic surgery
Objective To investigate the correlation between laparoscopic surgery's perioperative factors and postoperative delirium. Methods The patients undergoing laparoscopic surgery in Wuhan Sixth Hospital from May 2016 to January 2018 were included in the study. The general conditions of the patients included in the registry and the various perioperative influencing factors of the patients were recorded. The independent influencing factors of secondary postoperative delirium in patients undergoing laparoscopic surgery were studied by intergroup comparison and multivariate logistic regression analysis, in which whether the patient had secondary postoperative delirium within 3 days after surgery as the dependent variable and a number of potential influencing factors during the perioperative period of laparoscopic surgery as the independent variables. Results After screening according to inclusion and exclusion criteria, 803 patients who underwent laparoscopic surgery were included. Among them, 63 patients had secondary postoperative delirium within 3 days after laparoscopic surgery, and the remaining 740 patients had normal consciousness within 3 days after surgery. Comparison of the composition of surgical types between the two groups showed no significant difference (P > 0.05), and the data were comparable. Comparison of data between patients in different consciousness groups showed that there were significant differences in age composition, cerebral infarction, surgical grade, general anesthesia combined with epidural anesthesia, intraoperative pneumoperitoneum angle, surgical time, low SpO2 during anesthesia induction, partial pressure of carbon dioxide (PaCO2) after pneumoperitoneum, emergence agitation, serum neuron-specific enolase (NSE) (within 6 h after operation), and Ramsay score (1 h after operation) (P < 0.05). Multivariate logistic regression analysis showed that age composition, combined cerebral infarction, general anesthesia combined with epidural block anesthesia, intraoperative pneumoperitoneum angle, low SpO2 during anesthesia induction, and NSE (within 6 h after surgery) entered the regression model (P < 0.05), in which general anesthesia combined with epidural block anesthesia was an independent protective factor; age composition, combined cerebral infarction, intraoperative pneumoperitoneum angle, low SpO2 during anesthesia induction, and NSE content within 6 h after surgery were independent risk factors. Conclusion Clinicians should pay more attention to the patients with definite influencing factors and carry out relevant screening in time, so as to achieve early detection and early intervention and effectively avoid the occurrence of postoperative delirium.
Laparoscopy / Postoperative delirium / Influencing factors {{custom_keyword}} /
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