胺和普罗波对老年患者认知功能的影响:系统性审查
Gilles Van de Vel1, Sojeong Mun2, Shahab Ud Din Zia3
1Hospital Medicine, King's Mill Hospital, Mansfield, GBR.
麻醉选择会影响老年人的认知能力. 虽然胺和普罗波可能会增加术后认知功能障碍 (POCD) 的风险,但与吸入剂相比,普罗波可以减轻POCD.
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:
- 麻醉对老年人的认知功能的影响仍在争论中.
- 老年人麻醉诱导的认知变化的病理生理学尚不清楚.
研究的目的:
- 系统地审查胺和普罗波对老年患者认知功能的影响.
- 分析与这些麻醉剂相关的术后认知功能障碍 (POCD) 和术后妄 (POD) 风险.
主要方法:
- 按照PRISMA指南进行系统审查.
- 在多个数据库 (PubMed,CENTRAL等) 进行了搜索. 在2024年11月17日之前.
- 评估了19项研究 (3,149名参与者,主要是RCT) 使用Cochrane偏差风险-2和纽卡斯尔太华规模.
主要成果:
- 胺和普罗波与雷米马佐拉姆和德克斯梅德托米丁相比,显示POCD风险增加类似.
- 凯托福减少了POD发病率与安慰剂相比;较高的普罗波福尔剂量增加了POD发病率/严重程度.
- 普罗波比吸入麻醉剂更有效地减轻POCD.
结论:
- 麻醉剂的选择对于老年患者的认知结果至关重要.
- 需要进一步的大规模试验来证实这些发现并评估长期的认知影响.
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