成人手术患者中的石胺和神经认知障碍:元分析
Xing Lin1,2, Xin Liu1,3, Huoming Huang1,2
1Yangzhou University Medical College, Yangzhou, 225000, China.
BMC anesthesiology
|December 5, 2024
概括
静脉注射的斯基坦胺显著降低了手术后痴呆症和手术患者认知功能障碍的风险. 这种麻醉辅助剂还降低了阿片类药物需求和术后恶心和吐.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 之前的元分析证实了胺胺的神经保护潜力.
- 对于预防外科手术期间神经认知障碍 (PND) 的疗效尚不确定.
- 这一元分析评估了艾斯基坦胺对成人手术患者PND的影响.
研究的目的:
- 综合评估静脉注射乙胺对PND的影响.
- 评估埃斯基坦胺对术后痴呆症 (POD) 和认知功能障碍 (POCD) 的影响.
- 分析二次结果,包括疼痛,阿片类药物消费和恶心/吐.
主要方法:
- 系统地搜索电子数据库和试验注册表.
- 包括随机对照试验在外科手术期间使用石胺.
- 主要结局:POD和POCD风险;次要结局:认知状态,疼痛,雷米芬坦尼尔使用,PONV.
主要成果:
- 乙胺降低了POD风险 (RR 0.46) 和POCD风险 (RR 0.50).
- 在手术后4,24和48小时观察到显著的认知改善.
- 减少了手术内使用雷米芬坦尼尔 (SMD -0.56) 和PONV风险 (RR 0.64).
结论:
- 静脉注射的乙胺是一种有益的辅助剂,可以降低PND易感性.
- 素有助于预防POD和POCD.
- 它降低了手术期间的阿片类药物需求和手术后的疼痛,而不会增加PONV.
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