内科手术时使用的甲基蓝对接受关节置换的老年患者手术后妄想的作用 随机对照试验
Wen Zhang1,2, Fei Ling1,2, Junwei Qi1,2
1Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
甲蓝 (MB) 输液显著降低了老年关节置换患者的手术后狂妄症 (POD). 虽然发烧更常见,但整体不良事件相似,表明MB.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 手术并发症 手术并发症
背景情况:
- 手术后痴呆症 (POD) 是关节置换手术后的常见并发症,严重影响患者的治疗结果.
- 甲蓝 (MB) 已经显示出降低POD发病率的潜力.
研究的目的:
- 为了研究手术内甲蓝 (MB) 在减少手术后妄 (POD) 在接受关节置换手术的老年患者的发生率方面的疗效.
主要方法:
- 一项随机对照试验,涉及217名接受关节置换手术的老年患者.
- 在麻醉诱导期间,患者被分配接受甲蓝 (MB) (2 mg/kg IV) 或安慰剂 (5%葡萄糖溶液).
- 主要终点是手术后五天内POD的发生率;次要结果包括妄想特征,疼痛得分,认知功能和不良事件.
主要成果:
- 在MB组 (8.3%) 的POD发病率明显低于对照组 (20.4%) (P=0.024).
- 手术后发烧在MB组 (16.5%) 发生的频率高于对照组 (7.4%) (P=0.039).
- 两组之间在其他不良事件中没有发现显著差异.
结论:
- 在手术期间静脉注射甲蓝 (MB) 有效地降低了接受关节置换手术的老年患者手术后妄想症 (POD) 的发生率.
- 尽管手术后发烧率较高,但MB输液并没有显著增加不良事件的总体发生率或严重程度.
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