德克斯梅德托米丁剂量对接受心脏手术的老年患者短期认知功能的影响
Jun Fang1, Jia Yang1, Mingyu Zhai1
1Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
BMC anesthesiology
|November 21, 2023
概括
在心脏手术后,较低的外科手术期间的德克斯梅德托米丁 (DEX) 输液率改善了老年人的短期认知功能. 低剂量DEX输液 (0.1-0.5μg/kg/h) 与较高剂量相比,提升了早期的术后认知得分.
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:
- 手术后认知功能障碍是接受心脏手术的老年患者的一个担忧.
- 德克斯梅德托米丁 (DEX) 通常用于手术期间的镇静和止痛.
- 为了保持认知功能,最优的外科手术期间的DEX输注速率仍然不清楚.
研究的目的:
- 为了研究不同外科手术期间的德克斯梅德托米丁 (DEX) 输注速率对接受心脏手术的老年患者短期术后认知功能的影响.
- 为了比较低剂量和高剂量DEX输液组之间的认知结果.
主要方法:
- 接受心脏手术的60岁及以上的88名患者被分为两组:低剂量DEX (0.1-0.5μg/kg/h) 和高剂量DEX (0.5-0.9μg/kg/h).
- 德克斯梅德托米丁输液在气管输入后开始,并持续到输出前1小时.
- 在术后第2,7,14和28天使用迷你精神状态检查 (MMSE) 评估认知功能.
主要成果:
- 与高剂量组 (H组) 相比,接受低剂量DEX (L组) 的患者在术后第二天显示出明显更高的MMSE得分 (p=0.046).
- 在随后的时间点 (第7天,第14天,第28天) 之间没有观察到MMSE得分的显著差异.
- 高剂量DEX组的低血压和胆心率较高 (分别为p=0.044和p=0.047).
结论:
- 低剂量外科手术期间的德克斯梅德托米丁输液 (0.1-0.5μg/kg/h) 改善了心脏手术的老年患者的早期术后认知功能.
- 较高的DEX输注速率可能与低血压和胆心病的风险增加有关.
- 优化DEX输注速率对于减轻这种患者群体的认知衰退和不良血液动力学事件至关重要.
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