无阿片类药物麻醉与esketamine对接受胸腔镜手术的老年患者的术后认知功能障碍的影响:一个前性,随机化,受控试验
Yuening Zhan1, Zhaohui Liu1, Song Meng1
1Department of Anesthesiology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, People's Republic of China.
Drug design, development and therapy
|December 22, 2025
概括
基于esketamine的无阿片类药物麻醉 (OFA) 在接受胸腔镜手术的老年患者中没有显著减少术后认知功能障碍 (POCD). 然而,OFA改善了反应时间,并稳定了手术后的血液动力学.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 胸部外科手术 胸部外科手术
背景情况:
- 手术后认知功能障碍 (POCD) 在胸腔镜手术后的老年患者中很常见.
- 对于POCD的有效干预和麻醉风险因素仍然不清楚.
研究的目的:
- 评估基于乙胺的无阿片类药物麻醉 (OFA) 对接受胸腔镜肺癌手术的老年患者的POCD的影响.
主要方法:
- 80名老年患者被随机分配到OFA (以乙胺为基础) 或控制 (以阿片类药物为基础) 麻醉组.
- 主要结局:POCD发病率在3天内.
- 后勤回归确定了POCD风险因素.
主要成果:
- 在OFA组中,POCD发病率为20%,对照组为42.5% (p=0.054).
- 手术后1天和3天,OFA组表现出改善的简单反应时间 (p<0.05).
- 在OFA组中,手术内血动力学 (MAP,HR,CO,CI,SV,SVRI) 较为稳定 (p<0.05).
- 波多野结衣综合症的危险因素包括年龄,心脏输出变化和第一个止痛要求的时间.
结论:
- 在这项研究中,以石胺为基础的OFA并没有显著降低POCD发病率.
- OFA与手术后反应时间的改善和手术内血液动力学波动的减少有关.
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