整体和区域麻醉后的术后妄想和认知功能障碍:系统性审查和元分析
Dmitriy Viderman1, Fatima Nabidollayeva2, Mina Aubakirova1
1Department of Biomedical Sciences, Nazarbayev University School of Medicine (NUSOM), Kerei and Zhanibek Khandar Str. 5/1, Astana 010000, Kazakhstan.
Journal of clinical medicine
|May 27, 2023
概括
全身麻醉 (GA) 和区域麻醉 (RA) 在预防术后妄 (POD) 或认知功能障碍 (POCD) 方面没有显著差异. 这一发现对于越来越多的手术过程中的患者安全至关重要.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 外科手术的结果
背景情况:
- 术后神经认知障碍包括术后妄 (POD) 和术后认知功能障碍 (POCD).
- 越来越多的外科手术需要确定最能保持认知功能的麻醉类型.
- 将全身麻醉 (GA) 和区域麻醉 (RA) 进行比较对于患者的安全至关重要.
研究的目的:
- 为了比较全身麻醉 (GA) 与区域麻醉 (RA) 的神经认知效应.
- 为了确定在外科手术过程中保持认知功能的更安全的麻醉选择.
主要方法:
- 对手术后认知结果的随机对照研究 (RCT) 的系统搜索.
- 对13项涉及3633名成年患者的RCT的元分析 (RA组1823名,GA组1810名).
主要成果:
- 在GA和RA之间,术后妄想 (POD) 的发生率没有统计学上显著的差异.
- 在两个麻醉组之间没有观察到术后认知功能障碍 (POCD) 的显著差异.
- 在GA和RA之间,术后死亡率没有差异.
结论:
- 全身麻醉和区域麻醉在POD的发生率方面似乎同样安全.
- 区域麻醉和全身麻醉在不同时间点 (一周,三个月) 对POCD的影响并不不同.
- 在GA和RA之间的选择似乎不会影响短期或中期的认知结果或死亡率.
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