成人外科患者の集中治療室での術後妄想の発生率と術後リスク要因 - 遡及的なコホート研究

Kotoe Kamata¹, Satoshi Hagihira²

¹Department of Anaesthesiology and Perioperative Medicine, Tohoku University School of Medicine, Miyagi, Japan.

Indian journal of anaesthesia

|August 29, 2025

まとめ

術後の妄想 (POD) は,長時間の麻酔に関連しています. 麻酔期間を最小限に抑えると,集中治療室 (ICU) の患者のPOD発症率が低下する可能性があります.

科学分野:

麻酔科
クリティカルケア医療
高齢者医療

背景:

術後の妄想 (POD) は患者の回復に影響を及ぼし,死亡率を増加させる重大な合併症です.
術後のリスク要因を特定することは PODの管理に不可欠です.
この研究は,集中治療室 (ICU) のPODに影響を与える麻酔因子に焦点を当てています.

研究の目的:

術後の妄想 (POD) に寄与する麻酔因子を評価する.
ICU患者におけるPODの変更可能な危険因子を特定する.
PODの発生率を減らすための戦略を策定する.

主な方法:

プロポフールまたはデスフルランによる麻酔を受けた1,040人の患者の遡及レビュー.
意図的な術後鎮静や機械呼吸器を使用した患者を除外する.
集中治療室の混同評価法と多変量ロジスティック回帰分析を用いてPODの評価

主要な成果:

術後の妄想 (POD) は患者の4. 1%で発生した.
PODの独立予測因子には,高齢者,アメリカ麻酔学会 - 身体状態 (ASA-PS),手術場所,麻酔時間,気管切除が含まれています.
PODの患者は高齢で,手術前の健康状態が悪く,麻酔/手術の時間が長かった.

結論:

長期麻酔はPODの変化する危険因子です
麻酔期間を最小限に抑えるとPODの発生率が低下する可能性があります.
術後72時間以上持続する妄想については,さらなる評価が推奨されます.

キーワード:

麻酔薬認知障害妄想するデスフルラン一般的な集中治療室術後の状態プロポポールリスク要因

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