Risk factors of delayed recovery from general anesthesia in patients undergoing radical biliary surgery

Abstract

Delayed recovery (DR) is very commonly seen in the patients undergoing laparoscopic radical biliary surgery, we aimed to investigate the potential risk factors of DR in the patients undergoing radical biliary surgery, to provide evidences into the management of DR. Patients who underwent radical biliary surgery from January 1, 2018 to August 31, 2020 were identified. The clinical characteristics and treatment details of DR and no-DR patients were compared and analyzed. Multivariable logistic regression analyses were conducted to identify the potential influencing factors for DR in patients with laparoscopic radical biliary surgery. We included a total of 168 patients with laparoscopic radical biliary surgery, the incidence of postoperative DR was 25%. There were significant differences on the duration of surgery, duration of anesthesia, and use of intraoperative combined sevoflurane inhalation (all P < .05), and there were not significant differences on American Society of Anesthesiologists, New York Heart Association, tumor-lymph node- metastasis, and estimated blood loss between DR group and control group (all P > .05). Multivariable logistic regression analyses indicated that age ≥70 years (odd ratio [OR] 1.454, 95% confidence interval [CI] 1.146–1.904), body mass index ≥25 kg/m 2 (OR 1.303, 95% CI 1.102–1.912), alcohol drinking (OR 2.041, 95% CI 1.336–3.085), smoking (OR 1.128, 95% CI 1.007–2.261), duration of surgery ≥220 minutes (OR 1.239, 95% CI 1.039–1.735), duration of anesthesia ≥230 minutes (OR 1.223, 95% CI 1.013–1.926), intraoperative combined sevoflurane inhalation (OR 1.207, 95% CI 1.008–1.764) were the independent risk factors for DR in patients with radical biliary surgery (all P < .05). It is clinically necessary to take early countermeasures against various risk factors to reduce the occurrence of DR, and to improve the prognosis of patients.

Delayed discharge from post-anesthesia care unit: A 20-case retrospective series

“…The main factors responsible for delayed awakening following anesthesia were longer duration of surgery, anesthesia, and high-dose anesthetic medications used during the operative period. [ 10 , 11 ] Despite with the widespread use of rapid acting anesthetic agents, patients often awaken quickly after surgery. Certain underlying organ dysfunction and metabolic disorders may also cause delayed awakening following anesthesia, such as old age, liver disease, renal disease, hypoalbuminemia, electrolyte imbalance, hyper/hypo-glycemia, and hypoxia.…”

Dexmedetomidine plus Bupivacaine versus Bupivacaine Alone in Pararectus and Intercostal Blocks in Abdominoplasty: A Randomized Comparative Study

“…Any complications including hypotension (20% drop in mean arterial pressure from its nadir value for five minutes [15] ), bradycardia (heart rate < 60 bpm at two readings five minutes apart [15] ), vomiting, and delayed recovery (no recovery two hours after surgery, and the patient not correctly responding to verbal commands or other external stimuli [16] ) were recorded.…”