低剂量抽胺对术后神经认知功能障碍在老年患者进行全身麻醉的胃肠道瘤的影响:一个随机对照试验
Jiamin Ma1,2,3, Fuquan Wang1,2, Jingxu Wang1,2
1Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
Drug design, development and therapy
|July 6, 2023
概括
低剂量艾斯基他明降低了因胃肠道瘤接受手术的老年患者的神经认知恢复的延迟. 这种干预也改善了血液动力学,减少了疼痛和心血管事件.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 在瘤学瘤学.
背景情况:
- 术后神经认知功能障碍 (PND) 是老年患者的一个重大问题,特别是在重大手术后.
- 在全身麻醉下进行的胃肠道瘤手术存在PND的风险,影响患者的治疗结果.
- 优化麻醉管理以减轻PND对于这个脆弱的人群至关重要.
研究的目的:
- 为了研究手术内低剂量乙胺在预防手术后神经认知功能障碍 (PND) 的疗效.
- 评估胺对经过胃肠道瘤手术的老年患者神经认知恢复延迟 (DNR) 的影响.
- 评估二次结果,包括手术内参数和术后疼痛.
主要方法:
- 一项随机对照试验,涉及68名接受胃肠道瘤全身麻醉的老年患者.
- 患者被分配给接受低剂量乙胺输注 (0.25 mg/kg负载,0.125 mg/kg/h) 或正常盐水 (对照).
- 主要结局是延迟神经认知恢复 (DNR) 的发生率;次要结局包括PND,疼痛和血液动力学稳定性.
主要成果:
- 与对照组 (38.71%) (P <0.05) 相比,乙胺组 (16.13%) 的DNR发病率明显较低.
- 乙胺组显示,手术内使用雷米芬坦尼尔和多巴胺减少,低血压和低心率的发病率较低.
- 术后疼痛评分 (NRS) 在3天后在乙胺组较低.
结论:
- 经过胃肠道瘤手术的老年患者内科低剂量乙胺的使用可以减少延迟神经认知恢复的发生率.
- 乙胺改善了手术内血动力学,降低了心血管不良事件,并减少了阿片类药物消费.
- 这些发现表明,在这个患者群体中,胺胺是改善神经认知结果和疼痛管理的潜在辅助剂.
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