胺对老年麻醉的认知结果的影响:综合性综述
Shuyong You1,2, Zhaohui Li2
1Department of Anesthesiology, Luxian People's Hospital, Luzhou, Sichuan, China.
Frontiers in psychiatry
|August 14, 2025
概括
低剂量胺可以保护老年手术患者的认知能力,但高剂量可能会引起妄想. 需要更多的研究来确定最佳的胺在老年麻醉的使用对认知结果.
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:
- 胺,一个NMDA受体对抗剂,用于老年麻醉血动力稳定性和潜在的神经保护.
- 手术后认知功能障碍 (POCD) 和妄 (POD) 是老年手术患者的重大风险.
- 胺对这种人群的认知结果的影响尚不清楚,关于其神经保护性和神经毒性作用的证据相互矛盾.
研究的目的:
- 审查现有的关于胺对接受麻醉的老年患者认知功能影响的文献.
- 评估胺在老年手术患者中预防或加剧POCD和POD的潜力.
主要方法:
- 对随机对照试验 (RCT) 进行了全面的文献审查.
- 研究的重点是胺对老年麻醉中认知结果的影响.
主要成果:
- 低剂量的胺 (0.3-0.5 mg/kg) 显示出神经保护作用,减少了一些患者的认知功能障碍.
- 由于研究设计,患者种群,剂量和认知评估方法的变化,研究结果不一致.
- 胺的神经精神效应取决于剂量,较高的剂量与 Delirium 和幻觉的风险增加有关.
结论:
- 进一步进行大规模的多中心RCT是必要的,以确定老年患者最佳的胺剂量方案.
- 确定特定的老年患者小组,他们可以安全地接受胺,以避免认知并发症至关重要.
- 未来的研究应该探索多模式麻醉技术和长期认知结果,以确定胺在老年麻醉中的作用.
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