在接受重大腹部手术的老年患者中,手术内氧气度和手术后妄想:一项前性随机对照临床试验
Shunpan Ji1, Yue Shi1,2, Xiaojing Fan1
1Department of Anesthesiology, Air Force Medical Center, Beijing, China.
International journal of colorectal disease
|June 6, 2025
概括
在接受重大腹部手术的老年患者中,高度启发氧气 (FiO2) 并没有减少术后妄想 (POD). 建议根据患者个体需求对FiO2进行定位,因为100%的氧气在40%的FiO2.2上没有提供临床益处.
科学领域:
- 麻醉学和外科手术期间的医学.
- 神经科学是一个神经科学.
- 关键护理医学 关键护理医学
背景情况:
- 手术后妄 (POD) 是老年手术患者的一个重大问题.
- 大脑缺氧和缺血被确定为POD病理生理学的关键贡献者.
- 优化手术期间的氧化对缓解神经系统并发症至关重要.
研究的目的:
- 为了比较40%与100%吸入氧气 (FiO2) 对接受重大腹部手术的老年患者POD发病率的影响.
- 评估不同FiO2度对神经炎症和临床结果的影响.
- 为了确定更高的FiO2水平是否会降低POD和相关并发症的风险.
主要方法:
- 一项随机试验涉及160名接受重大腹部手术的老年患者.
- 在全身麻醉期间,患者被分配接受40%或100%的FiO2.
- 主要结局是3天内POD发生率;次要结局包括氧化,神经炎症标志物和临床结局.
主要成果:
- 在40%的FiO2 (6.4%) 和100%的FiO2 (3.9%) 组 (P=0.72) 之间没有观察到POD发病率的显著差异.
- 40% FiO2 组与100% FiO2 组相比,显示了较低的外科手术期间氧化参数.
- 两组之间在神经炎症标志物,肺部感染,疼痛评分或住院时间方面没有发现显著差异.
结论:
- 在此患者队列中,与40%的FiO2相比,100%的FiO2在手术内给予并没有降低POD发生率或神经炎症标志物.
- 高度氧气并没有增加肺部并发症,但没有提供额外的临床益处.
- 应该根据患者的具体要求来个性化内科FiO2,而不是采用普遍的高度方法.
相关概念视频
General Anesthesia: Overview
308
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
308
Stages of General Anesthesia
747
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
747
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
1.0K
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
1.0K
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
184
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
184


