在接受关节塑造手术的老年患者中,S-胺对术后妄想的作用:一项随机对照试验
Youzhuang Zhu1, Wei Feng2, Yang Zhao2
1Department of Anesthesiology, Shandong Provincial Key Medical and Health Laboratory of Anesthesia and Brain Function, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China; and Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
Anesthesiology
|October 14, 2025
概括
在接受部或膝盖关节整形手术的老年患者中,S-胺显著降低了术后狂妄症 (POD) 的风险. 这项研究强调了S-胺.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 全身麻醉可能会降低S-胺的神经保护作用,这可能导致之前的研究低估了它的有效性.
- 以前的研究可能高估了由于同时使用全身麻醉而出现术后妄想症 (POD) 的风险.
研究的目的:
- 为了研究S-胺在降低POD风险的有效性,当没有全身麻醉.
- 评估S-胺对接受重大骨科手术的老年患者POD的影响.
主要方法:
- 一项随机对照试验,涉及372名老年患者,在神经轴麻醉下接受部或膝关节整形术.
- 患者接受了S-ketamine (n=186) 或安慰剂 (n=186).
- 主要结局是手术后3天内POD的发生率;次要结局包括疼痛,阿片类药物使用和睡眠质量.
主要成果:
- 斯基他胺显著降低了POD风险 (8.06%对20.43%,P=0.002).
- 在术后第一天,S-胺组报告疼痛减少,救援止痛使用率降低.
- 在S-ketamine组中观察到幻觉,头和梦的发病率增加,尽管整体并发症仍然很低.
结论:
- 在接受部或膝盖关节整形手术的老年患者中,S-胺有效降低了POD的风险.
- 研究结果表明,S-ketamine在这种患者群体中是预防POD的可行选择.
- 可概括性可能受到特定研究环境的限制.
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