在老年人中使用大麻和吸入麻醉的管理:一种倾向匹配的回顾性队列研究
Ruba Sajdeya1, Masoud Rouhizadeh2, Robert L Cook1
1Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida.
Anesthesiology
|July 9, 2024
概括
使用大麻的老年人需要更高剂量的吸入麻醉剂,特别是异氨酸或氨酸最小膜度等价物. 然而,这种大麻使用关联的临床意义仍然不清楚.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 老年医学 老年医学
背景情况:
- 大麻使用量正在上升,但其对吸入麻醉剂需求的影响尚未得到充分了解.
- 以前的研究将大麻与更高的静脉麻醉剂量联系起来,但对吸入剂的数据有限.
- 了解这种关系对于优化老年人麻醉至关重要.
研究的目的:
- 为了比较异花或异花在老年人中与使用大麻和不使用大麻的平均手术内最小膜度 (MAC) 等值.
- 调查大麻消费与手术患者吸入麻醉剂剂量之间的潜在关联.
主要方法:
- 在一个主要的卫生系统 (2018-2020年) 进行了22476名65岁以上的手术患者的回顾性审查.
- 通过NLP,ICD代码,实验室结果和RxNorm确定的大麻使用;定义为手术后60天内使用.
- 根据基线特征,用于比较268名大麻使用者和1,072名非使用者的倾向分数匹配 (4:1).
主要成果:
- 在匹配后,大麻使用者与非使用者 (0.54 ± 0.22) 相比,获得了统计学上显著更高的平均最小膜度 (MAC) 等值 (0.58 ± 0.23).
- 在MAC的平均差异为0.04 (95%CI:0.01到0.06;P=0.020).
- 虽然在统计学上显著,但这种麻醉剂量差异的临床重要性是不确定的.
结论:
- 老年人使用大麻与更高的注射吸入麻醉剂MAC等价物有关.
- 目前尚不清楚这种观察到的麻醉需求差异的临床意义.
- 该研究不支持大麻使用者需要临床上有意义的吸入麻醉剂量增加的假设.
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