在心脏外科手术中,手术内用德克斯梅德托米丁对术后精神健康的影响:一项随机对照试验
Xinyu Hao1, Zhuoning Zhang1, Chen Cai1
1Department of Anesthesiology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
在心脏手术患者中,手术内用德克斯梅德托米丁在7天内显著降低了术后抑郁症,妄想,焦虑,睡眠障碍和疼痛. 然而,这些好处在30天后不再持续.
科学领域:
- 麻醉学和重症监护医学
- 心血管外科心血管外科
- 精神病学和心理学 精神病学和心理学
背景情况:
- 德克斯梅德托米丁经常用于心脏手术的麻醉.
- 手术后的抑郁和妄想是心脏手术患者的重大担忧.
- 评估手术时使用的德克斯梅德托米丁对这些结果的影响至关重要.
研究的目的:
- 评估手术内用德克斯梅德托米丁在预防成人心脏手术患者手术后抑郁症方面的安全性和有效性.
- 评估德克斯梅德托米丁对妄,焦虑,睡眠,疼痛和生活质量的影响.
主要方法:
- 一项随机,双盲,安慰剂对照试验,涉及200名接受心脏手术的成年患者.
- 患者接受了手术内注射德克斯梅德托米丁或安慰剂.
- 主要结局是使用患者健康问卷-9 (PHQ-9) 在术后7天进行抑郁查.
主要成果:
- 德克斯梅德托米丁在7天后显著降低了抑郁症的发生率 (11.0%与31.0%相比).
- 在7天后,在德克斯梅德托米丁组中观察到妄,焦虑,睡眠障碍和疼痛的减少率.
- 7天后,人们注意到生活质量的改善 (EQ-5D-5L得分),但差异减少了30天.
结论:
- 在心脏手术后7天内,手术内用德克斯梅德托米丁有效地减少了抑郁,妄想,焦虑,睡眠障碍和疼痛.
- 对这些结果的有益影响在30天的随访中没有持续.
- 在这个患者群体中,德克斯梅德托米丁似乎是安全的,并且能很好地耐受.
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