静脉麻醉对无痛胃镜患者手术后认知功能的影响:元分析
Zhen Jia1, Yubai Leng1, Yetie Fan1
1Department of Anesthesiology, Hainan Cancer Hospital, Affiliated Cancer Hospital of Hainan Medical College, NO. 9 Changbin West Street, Xiuying District, Haikou City, Hainan Province, 570100, China.
无痛胃镜的静脉麻醉在第7天显示术后认知功能障碍 (POCD) 的发生率较低. 这表明,与吸入麻醉相比,老年患者的认知能力下降的风险可能会降低.
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:
- 无痛的胃镜越来越多地使用静脉内麻醉.
- 麻醉药可以影响术后认知功能 (POCF),特别是在老年人中.
- 手术后认知功能障碍 (POCD) 是老年人的一个重大问题.
研究的目的:
- 为了评估静脉麻醉对POCF在接受无痛胃镜的老年患者的影响.
- 为了确定与静脉麻醉相关的POCD风险.
- 引导临床麻醉实践进行无痛的胃镜检查.
主要方法:
- 随机对照试验 (RCT) 的元分析.
- 搜索了PubMed,Embase,科学网,Scopus,Cochrane和临床关键. 这是一个很好的选择.
- 使用Cochrane偏差风险工具评估研究质量;使用RevMan 5.3.3进行元分析.
主要成果:
- 7项涉及219名患者的研究符合纳入标准.
- 在第1天和第3天的POCD发病率没有显著差异.
- 在静脉麻醉的第7天,POCD发病率较低 (OR=0.96,CI:0.73-1.26).
- 在静脉麻醉组显著降低S-100β蛋白水平 (神经损伤标志物) (MD=0.34,CI:0.23-0.48).
结论:
- 在老年人中,静脉麻醉可以降低无痛胃镜后的第7天POCD的风险.
- 在这种人群中,静脉麻醉似乎是更好地减少POCD风险.
- 需要进一步的大规模RCT来证实研究结果并探索人口影响.
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