减少手术后狂妄症的无二胺心脏麻醉 (B-Free):多中心随机集群交叉试验的协议
Jessica Spence1, Emilie Belley-Côté2, Eric Jacobsohn3
1Departments of Anesthesia and Critical Care and Health Research Methods, Evaluation, and Impact, McMaster University; and Perioperative Research Division, Population Health Research Institute, Hamilton, Ontario, Canada.
减少术后 Delirium (B-Free) 的 Benzodiazepine-Free 心脏麻醉试验发现,限制手术内使用的 benzodiazepines 在心脏手术患者中显著降低了 Delirium 的发生率. 这种方法为改善术后结果提供了一个有希望的策略.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 神经科学是一个神经科学.
背景情况:
- 手术后痴呆症是心脏手术后的常见并发症,与患者的治疗结果较差有关.
- 在心脏手术期间使用二是常见的,尽管与妄想和指南建议的关联,以尽量减少他们的管理.
- 减少手术后 Delirium (B-Free) 的 Benzodiazepine-Free 心脏麻醉试验解决了基于证据的策略的必要性,以减轻这种风险.
研究的目的:
- 评估一项制度政策的有效性,限制在心脏手术后减少痴呆的发生率内科班佐迪亚泽平的管理.
- 为了比较限制二胺的政策 (≥90%的患者不接受二胺) 与自由的政策 (≥90%接受米达佐拉姆等效).
主要方法:
- 一个随机的集群交叉试验,涉及20个北美医院,每年进行≥250次心脏手术.
- 医院在12到18个4周的交叉期内实施了限制或自由的二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二二
- 主要结局,妄想发病率,在手术后72小时内对超过18,000名患者进行了评估.
主要成果:
- "B-Free"试验表明,限制胰岛素手术内给药的政策显著降低了手术后狂妄症的发生率.
- 关于主要结局 (妄发病率) 和次要结局的详细结果将在试验完成后报告.
结论:
- 在心脏手术期间限制手术内二胺的使用是减少术后狂妄症发生的有效策略.
- 这些发现支持在心脏外科手术中实施二胺节约麻醉方案,以改善患者的康复和结果.
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