米达佐拉姆前期治疗和术后妄想之间的关联 - 一个回顾性队列研究
Shiri Zarour1, Yotam Weiss1, Yossef Kiselevich1
1Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
在老年手术患者中,米达佐拉姆前期治疗并没有增加术后狂妄症的风险. 在非心脏手术前,在70岁及以上的患者中可以安全地使用低剂量米达佐拉姆.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 外科手术的结果
背景情况:
- 手术后妄是老年手术患者的一个重大问题.
- 预药选择可能会影响术后妄想的发生率.
- 米达佐拉姆通常用于前期治疗.
研究的目的:
- 评估在70岁及以上的患者中,米达佐拉姆前期治疗和术后狂妄症之间的关联.
- 为了确定手术前给予米达佐拉姆是否会影响妄风险.
主要方法:
- 对1973年接受选择性非心脏手术的患者进行了回顾性队列研究.
- 米达佐拉姆前期治疗被定义为在麻醉诱导之前静脉注射.
- 使用复合结果评估的术后妄想,包括4A的测试,CHART-DEL和3D-CAM.
主要成果:
- 整体术后狂妄症发生率为15.3%.
- 米达佐拉姆前期治疗 (40%的患者) 并没有与术后狂妄症的几率增加有关 (aOR1.09,95% CI 0.82-1.45).
- 没有发现与其他术后并发症或敏感性分析的相关性.
结论:
- 低剂量米达佐拉姆前期治疗对于接受选择性非心脏手术的老年患者似乎是安全的.
- 在这个人群中,米达佐拉姆的使用并没有显著增加术后狂妄症的风险.
- 这些发现支持明智地使用米达佐拉姆在老年手术患者的前期治疗中.
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