ERAS理念下手术室护理术前访视与宣教对Mako机器人辅助下全髋关节置换术患者麻醉苏醒期躁动及苏醒质量的影响

Effects of Preoperative Visit and Education in Operating Room Nursing under ERAS Concept on Agitation and Quality of Recovery during Anesthesia and Recovery in Mako Robot-Assisted Total Hip Replacement Patients

摘要: 目的：旨在研究在加速康复外科(ERAS)理念引领下，对即将接受Mako机器人辅助全髋关节置换术的患者开展术前手术室护理访视与健康宣教，这会对患者麻醉苏醒期躁动以及苏醒质量产生何种影响。方法：以青岛大学附属医院为研究场所，研究对象确定为2024年1月至12月期间在此院行Mako机器人辅助全髋关节置换手术的108例患者。运用随机数字表法把这些患者分为观察组和对照组，两组人数均为54例。在观察组方面，除了常规护理之外，还会接受术前手术室护理访视与宣教，而对照组就只进行常规护理。对两组在麻醉苏醒期躁动的发生情况、苏醒质量、不良情绪(SAS、SDS)、疼痛评分(VAS)以及不良事件发生率等方面的差异进行比较。结果：结果表明，观察组术后的RASS评分(P = 0.011)、躁动发生率(P = 0.030)以及躁动持续时长(P = 0.004)均显著低于对照组；在苏醒情况这一维度上，气管拔管时长、PACU停留时长以及定向力恢复时长相较于对照组也更具优势(P < 0.05)；对照组相比，观察组的焦虑自评量表(SAS)、抑郁自评量表(SDS)评分以及视觉模拟评分法(VAS)疼痛评分均更低，且差异具有统计学意义(P < 0.05)；不良事件的发生率也低于对照组(P = 0.046)。结论：在ERAS理念的指引下，术前手术室护理访视与健康宣教相结合，能够让Mako机器人辅助全髋关节置换术患者的术后躁动发生率显著下降，苏醒质量得以优化，负面情绪得到缓解，术后恢复也能得到促进。

Abstract: Objective: The aim is to explore how the preoperative visit and education in operating room nursing within the ERAS concept impact agitation and the quality of recovery during anesthesia and recovery in patients undergoing Mako robot assisted total hip replacement. Methods: From January 2024 to December 2024, 108 patients who were to undergo Mako robot assisted total hip replacement surgery in the Affiliated Hospital of Qingdao University were selected as the study subjects. They were randomly divided into an observation group and a control group by the random number table method, with 54 cases in each group. For the study, in the operating room nursing part, the patients in the observation group were given preoperative visit and educational intervention, whereas the patients in the control group only received the regular nursing. A comparison was made between the two groups in terms of the emergence of agitation, the quality of recovery, the scores of adverse mood and pain, as well as the incidence of adverse events. Results: The RASS score (P = 0.011), incidence of agitation (P = 0.030), and duration of agitation (P = 0.004) in the observation group were significantly lower than those in the control group. Tracheal extubation time, PACU residence time, and orientation recovery time were significantly shorter than those in the control group (P < 0.05). The self-rating anxiety scale (SAS), self-rating depression scale (SDS), and pain score (VAS) were also significantly lower in the observation group (P < 0.05). The incidence of adverse events was significantly lower than that of the control group (P = 0.046). Conclusion: For patients who are going to have total hip replacement surgery with the assistance of Mako robots, preoperative nursing visits and education can contribute to reducing the incidence of agitation and other adverse outcomes during anesthesia recovery, enhancing the quality of postoperative recovery and speeding up the recovery process.