胺胺对术后认知的影响:一个范围审查
Connor T A Brenna1, Xuan W He2, Daheng Liu2
1Department of Anesthesiology & Pain Medicine, University of Toronto, Toronto, ON, Canada; Department of Physiology, University of Toronto, Toronto, ON, Canada; Perioperative Brain Health Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
在老年人手术后,胺并不能始终防止认知能力下降. 需要更多的研究来确定可能受益于胺胺神经认知保护的患者子组.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 老年病的医生 老年病的医生
背景情况:
- 术后妄想和神经认知缺陷在老年手术患者中很常见.
- 胺可以通过减少神经炎症和麻醉需求来提供认知保护.
- 它在预防外科手术前神经认知障碍方面的有效性仍然存在争议.
研究的目的:
- 总结关于胺胺在成年手术患者的认知节约作用的临床研究.
- 评估胺在预防外科手术期间神经认知障碍方面的证据.
- 确定潜在的好处和未来的研究方向.
主要方法:
- 临床试验和回顾性队列研究的范围审查.
- 在Embase和Embase经典数据库 (1947-2025) 中进行系统搜索.
- 包括研究评估认知后的racemic ketamine,esketamine,或arketamine的管理.
主要成果:
- 审查了58项涉及6830名患者的研究.
- 60%的研究发现胺没有任何认知益处.
- 40%的人报告神经认知障碍的发病率或持续时间降低,与剂量,酶体或时间不一致的发现.
结论:
- 目前关于胺的认知益处的证据是不一致和不确定的.
- 许多试验的实力不足和异质,排除了元分析.
- 需要进行更大规模,更精心设计的试验,以确定特定的患者亚组或胺可能有益的手术背景.
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