在非心脏手术后的手术内德克斯梅德托米丁和痴呆症之间的剂量依赖关系:一项回顾性队列研究
Elena Ahrens1,2, Luca J Wachtendorf1,2, Theresa Tenge1,2,3
1Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Anaesthesia
|February 20, 2026
概括
低剂量德克斯梅德托米丁 (DDX) 降低了手术后妄想症的风险. 预防狂妄的最佳DDX剂量范围在0.25至0.35μg/kg之间,更高的剂量显示没有益处.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 神经科学是一个神经科学.
背景情况:
- 已知德克斯梅德托米丁 (DDX) 可以减轻重症患者的妄想.
- 关于DDX对术后妄想的预防作用的证据是不确定的.
- 这项研究研究了在手术内给药DDX后出现痴呆症的剂量依赖风险.
研究的目的:
- 为了确定手术内用德克斯梅德托米丁 (DDX) 剂量是否会影响术后狂妄症的风险.
- 确定非心脏,非移植手术后减轻痴呆症的最佳DDX剂量.
主要方法:
- 对114,786名接受全身麻醉的成年患者进行了回顾性分析.
- 在手术期间的DDX剂量 (累计μg/kg) 被分为低 (≤0.49μg/kg) 或高 (>0.49μg/kg).
- 在7天内进行术后妄想,使用出院说明,混评估方法和诊断代码进行识别.
主要成果:
- 4804名患者接受了DDX (中位数剂量:0.49μg/kg).
- 在2.8%的患者中发生了术后妄想.
- 低剂量的DDX与妄风险降低有关 (aOR0.61;P=0.004),而高剂量的DDX没有显著影响 (aOR1.06;P=0.62).
- 据估计,最低的妄想风险的最佳DDX剂量在0.250.35μg/kg之间.
结论:
- 低剂量德克斯梅德托米丁 (DDX) 的使用与手术后妄想症的风险降低有关.
- 高剂量的DDX并没有对妄产生保护作用.
- 预防狂妄症的最佳手术内DDX剂量范围是0.250.35μg/kg.
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