在接受短期手术的老年患者中,无阿片类药物和阿片类药物全静脉麻醉的比较:随机对照试验
Shirong Wei1, Sitong Zhou1, Junwen Tu1
1Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, Jiaxing China.
Annals of medicine
|February 9, 2026
概括
与基于阿片类药物的麻醉 (OBA) 相比,无阿片类麻醉 (OFA) 在接受短期手术的老年人中显著减少了重大术后不良事件. 通过降低低氧血和恶心,OFA改善了结局,但需要仔细管理心和输出管的时间.
科学领域:
- 麻醉学 麻醉学
- 老年人手术是一门老年人手术.
- 在外科手术期间的医学.
背景情况:
- 老年人在短期手术后容易患上与阿片类药物相关的并发症.
- 无阿片类药物全静脉麻醉 (OFA) 在缓解这些事件的有效性仍然不确定.
研究的目的:
- 为了比较OFA和基于阿片类药物的标准静脉全麻醉 (OBA) 之间的重大术后不良事件的发生率.
主要方法:
- 一个单中心随机临床试验,涉及400名年龄≥60岁的患者,接受选择性,短期手术.
- 患者被随机分配1:1接受OFA或OBA.
- 主要结局是48小时内术后低氧化,妄或恶心和吐 (PONV) 的复合结果.
主要成果:
- 主要综合结果发生在OFA组的25.0%与OBA组的43.5% (调整后几率比,0.40;p <.001).
- 在OFA中,低氧化血症 (15.0%与32.0%) 和PONV (8.0%与16.0%) 的发病率较低.
- OFA组经历了更大的手术内血动力学稳定性,但患上白心率更高 (10.0%vs3.0%),输出时间更长 (9.5vs7.2分钟).
结论:
- 在接受短期手术的老年人中,OFA是OBA的可行替代品,可以改善术后的结果.
- OFA有效地降低了低氧化和PONV,但需要仔细管理潜在的副作用,如心肌梗塞和延长的输出管.
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