关键词: 全身麻醉, 意识障碍, 围术期麻醉管理

Abstract: Objective  To describe the clinical characteristics of patients with prolonged disorders of consciousness (pDOC) under general anesthesia and explore the perioperative clinical factors associated with the improvement of postoperative consciousness in pDOC patients. Methods  We retrospectively collected the medical records and surgical anesthesia data of pDOC patients undergoing elective surgery at Beijing Tiantan Hospital，Capital Medical University from February 2022 to December 2022. The Logistic regression was applied to explore the relationship between postoperative disturbance of consciousness in pDOC patients and perioperative clinical factors. Results  The study included 122 patients who underwent elective general anesthesia, including 72 patients (59.0%) in the vegetative state (VS/UWS) and 50 patients (41.0%) in the minimally conscious state (MCS). A significant improvement in the level of consciousness was observed in 27 patients with pDOC in the hospital after the operation. After using the Logistic regression model to adjust for age, the American Society of Anesthesiologists classification of physical status (ASA) grade, surgical method, sufentanil dosage, remifentanil dosage, awakening time and other related variables, the study found that intraoperative sufentanil dosage (OR=17.23, 95% CI： 1.22－224.30, P=0.035) and recovery time (OR=1.03, 95% CI： 1.00－1.05, P=0.046) were associated with the improvement in postoperative consciousness in the hospital. Conclusion  The short-term postoperative improvement in the hospital consciousness of patients with pDOC may be related to perfect intraoperative analgesia. The recovery time after general anesthesia is expected to be a potential factor predicting the improvement of consciousness in patients with pDOC.

Key words: general anesthesia, disorders of consciousness, perioperative anesthesia management