一项前性随机研究检查了静脉注射与吸入麻醉对术后认知衰退和妄想的影响
Thomas J Farrer1, Terri G Monk2, David L McDonagh3
1WWAMI Medical Eduction Program, University of Idaho, Moscow, ID, United States.
Applied neuropsychology. Adult
|August 12, 2023
概括
麻醉类型不会影响老年人手术后的认知衰退. 预先存在的认知功能和日常生活能力是术后认知衰退和妄想的关键预测因素.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 神经科学是一个神经科学.
背景情况:
- 手术后认知能力下降 (POCD) 是老年人的一个问题.
- 在POCD中麻醉类型的作用仍然不清楚.
- 手术前的认知状态和功能能力可能会影响结果.
研究的目的:
- 调查麻醉类型是否影响老年人POCD的发展.
- 为了比较吸入麻醉 (ISO) 与全静脉麻醉 (TIVA) 关于认知结果.
- 为了确定POCD和手术后妄想症的预测因素.
主要方法:
- 一项前性随机研究,比较ISO (异花) 和TIVA (propofol) 在维持麻醉方面.
- 患者接受了基线和随访神经心理评估 (3-18个月).
- 进行了痴呆症查和日常生活活动 (ADLs) 的评估.
主要成果:
- 在ISO和TIVA组之间,记忆或执行功能的平均变化没有显著差异.
- 麻醉类型没有预测POCD.
- 较低的手术前认知功能和ADLs预测POCD和痴呆症,分别.
结论:
- 麻醉类型 (ISO与TIVA) 并没有显著影响老年人的认知结果或妄想发病率.
- 手术前的认知功能是POCD的主要预测因素.
- 功能状态 (ADLs) 预测了手术后痴呆症的发展.
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