Occurrence and risk factors of emergence agitation in patients undergoing thoracic surgery under general anesthesia

Fan Leirong; Gao Yang; Qi Haini; Zhang Rong; Zhang Na; Lyu Qian; Sun Bing

doi:10.11986/j.issn.1673-873X.2024.12.20

Abstract：Objective To explore the occurrence of emergence agitation(EA)in patients undergoing thoracic surgery under general anesthesia and analyze its risk factors,aiming to provide a reference for preventing the occurrence of EA in thoracic surgery patients.Methods A total of 214 patients who underwent thoracic surgery under general anesthesia at the Second Affiliated Hospital of Air Force Medical University between June 2022 and June 2024 were selected for this study.Among them,38 patients who developed EA were included in the EA group,and 176 patients who did not develop EA were included in the Non-EA group.General data,surgical-related factors,and anesthesia-related factors were compared between the two groups,and a multivariate logistic regression analysis was performed to identify the risk factors for EA in thoracic sur-gery patients under general anesthesia.Results The incidence of EA in this study was 17.76%.The proportion of patients in the EA group with BMI>25 kg/m2 and a history of long-term use of psychiatric medications was higher than in the Non-EA group,with significant differences(P<0.05).The proportion of patients in the EA group undergoing emergency sur-gery and having indwelling catheters was higher than in the Non-EA group,with significant differences(P<0.05).There was a significant difference in ASA classification between the two groups(P<0.05).The proportion of patients in the EA group receiving intravenous inhalational combined anesthesia and not using postoperative analgesia was higher than in the Non-EA group,with significant differences(P<0.05).Multivariate logistic regression analysis revealed that emergency surgery(OR=1.970,95%CI:1.060-3.660),indwelling catheter(OR=1.706,95%CI:1.093-2.662),ASA classifica-tion Ⅲ(OR=1.476,95%CI:1.135-1.919),and not using postoperative analgesia(OR=1.844,95%CI:1.224-2.778)were independent risk factors for EA in thoracic surgery patients under general anesthesia(P<0.05).Conclusion Emergency surgery,indwelling catheter,ASA classification Ⅲ,and not using postoperative analgesia are independent risk factors for EA in thoracic surgery patients under general anesthesia.Clinical monitoring and management of these high-risk patients should be strengthened,and targeted measures should be taken to reduce the risk of EA.