在接受重大骨科手术的老年患者中,手术内氧酸对术后痴呆的预防作用:一项随机临床试验
Meiying Cui1,2, Hang Xue1, Fang Wang1
1Department of Anesthesiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, 110004, China.
在接受早晨骨科手术的老年患者中,预防性手术内氧酸盐 (SO) 降低了术后妄想 (POD). 这项研究表明POD预防的潜在慢性治疗方法具有可接受的安全性.
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:
- 手术后妄 (POD) 是老年手术患者的一个重大挑战,与不良结果有关.
- 睡眠障碍是POD的一个可修改的风险因素.
- 氧酸 (SO) 是GABAB激动剂,具有增强睡眠的特性,可以预防POD.
研究的目的:
- 调查预防性手术内氧酸盐 (SO) 是否降低了经历重大骨科手术的老年患者 (≥65岁) 的POD发病率.
主要方法:
- 一项随机,双盲,安慰剂对照试验,涉及332名接受骨科手术的老年患者.
- 参与者接受了SO (30毫克/公斤) 或盐水的麻醉后诱导.
- 使用混评估方法 (CAM) 在术后七天内评估POD发病率.
主要成果:
- 在SO和安慰剂组之间,整体POD发病率没有显著差异 (10.3%与13.5%).
- 亚组分析显示,在接受SO的早间手术患者中,POD显著减少 (7.3%对18.5%,P=0.033).
- 没有观察到痴呆症严重程度,睡眠质量,疼痛或安全参数的显著差异.
结论:
- 氧酸盐在手术内显示出特定时间的疗效,主要在接受早晨骨科手术的老年患者中减少POD发病率.
- SO 提出了一个潜在的慢性治疗策略,用于预防POD.
- 治疗显示了可接受的安全性,没有对麻醉恢复或血液动力学产生不良影响.
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