镇静前治疗对全身麻醉后患者体验的影响:一项随机临床试验
Axel Maurice-Szamburski1, Pascal Auquier2, Véronique Viarre-Oreal1
1Service d'Anesthésie Réanimation, Hôpital de la Timone Adulte, Marseille, France.
JAMA
|March 4, 2015
概括
服用洛拉泽的镇静前期治疗并没有改善手术后患者的满意度. 它与更长的输出时间和减少早期认知恢复有关,质疑其常规使用.
科学领域:
- 麻醉学 麻醉学
- 在外科手术期间的医学.
- 患者体验 患者体验
背景情况:
- 镇静药前治疗是手术前的常见做法,但支持其有效性的强有力的临床证据有限.
- 在PremedX研究中,研究了常规镇静前期治疗对患者结局的影响.
研究的目的:
- 评估使用洛拉泽帕姆镇静剂前期治疗对外科手术期间患者经验的有效性.
- 评估二次结果,包括输出管的时间和早期的认知恢复.
主要方法:
- 一项随机临床试验 (PremedX研究) 涉及1062名成人患者,在全身麻醉下接受选择性手术.
- 患者被随机分配给接受洛拉泽帕姆,没有前期治疗或安慰剂.
- 在术后24小时使用经过验证的Evan-G问卷测量了患者的经验.
主要成果:
- 与安慰剂或没有前期治疗相比,洛拉泽帕姆前期治疗没有显著改善整体患者满意度得分.
- 对高预手术焦虑症患者的亚组分析也显示,满意度没有显著差异.
- 与其他组相比,接受洛拉泽帕姆的患者经历了更长的输出时间和较低的早期认知恢复率.
结论:
- 常规用洛拉泽进行镇静前治疗,不会改善选择性手术后的患者体验.
- 洛拉泽帕姆的使用与术后延迟的输出和认知功能受损有关.
- 这些发现表明,在全身麻醉中作为前期治疗的洛拉泽帕姆的常规服药可能没有益处.
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