术内建议,以预防手术后狂妄症的患者接受关膜置换:一个随机的安慰剂对照试验
Christina Kaufmann1, Nina Zech1, Florian Brandt1
1Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany.
Aging clinical and experimental research
|July 1, 2023
概括
在手术期间的音乐和积极的建议没有减少手术后妄 (POD) 在接受TAVR的老年患者. 男性性别和较低的认知分数与POD风险增加有关.
科学领域:
- 麻醉学和外科手术期间的医学.
- 老年医学 老年医学
- 心血管外科心血管外科
背景情况:
- 手术后痴呆症 (POD) 是麻醉和手术后老年患者的一个重大并发症.
- 在手术期间的音乐和积极的建议已经显示出改善术后结果的潜力.
- 过导管大动脉置换 (TAVR) 是老年人群中越来越常见的一种手术.
研究的目的:
- 调查手术期间音乐的影响和对POD发病率的积极建议.
- 评估对疼痛,止痛需求以及术后恶心和吐 (PONV) 的影响.
- 为了检查老年患者在全身麻醉下接受TAVR的POD发展.
主要方法:
- 一项随机的安慰剂受控研究,涉及在全身麻醉下接受TAVR的患者.
- 患者接受了手术期间的音乐和积极的建议或安慰剂.
- 使用混评估方法-重症监护室 (CAM-ICU) 和护理狂妄查量表 (Nu-DESC) 评估了术后狂妄症.
主要成果:
- 在12.7%的患者中诊断出术后妄想症 (POD).
- 在男性和患有较低迷你精神状态检查 (MMSE) 评分的患者中,POD的频率明显更高.
- 在手术期间的音乐和建议并没有显著改变POD,疼痛,止痛药的发生率,或PONV.
结论:
- 男性性别和较低的基线认知功能 (低MMSE得分) 是TAVR患者POD的风险因素.
- 在手术期间的音乐和积极的建议似乎不会影响这个患者队列中POD的发病率.
- 可能需要进一步的研究来确定有效的干预措施,以预防TAVR患者的POD.
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