JAMA Surg:术中注射右美托咪定不会改善老年患者术后谵妄的发病率

2017-06-16 zhangfan MedSci原创

术中注射右美托咪定不会改善老年患者术后谵妄的发病率

10%-60%的老年大手术患者会发生术后谵妄,导致住院时间延长,住院费用增加和1年死亡率增加。最新研究表明,ICU使用右美托咪定镇静与谵妄发病率降低有关。但术中使用右美托咪啶对谵妄预防效果尚不知晓。近日研究人员就术中注射右美托咪定对减少术后谵妄的作用开展研究。

在这项多中心、双盲、随机、对照研究中,患者随机在术中以及术后2小时注射右美托咪啶(0.5 μg/kg/h)或安慰剂。主要终点是每天的术后谵妄评估,次要终点是右美托咪定与术后认知功能的关系。参与研究的患者为68岁以上的择期非心脏大手术患者。

研究招募了404名患者,其中390人完成院内谵妄评估(平均年龄74.0岁,51.3%为女性)。研究发现术后谵妄评估在右美托咪定组和安慰剂组之间无显著差异 (12.2% [23人] vs 11.4% [23人], P=0.94)。在对患者年龄以及教育水平进行调整后,治疗组与安慰剂组之间,3个月和6个月术后认知能力无显著差异。治疗组不良事件发生率高于对照组。

研究认为术中注射右美托咪定不会改善老年患者术后谵妄的发病率。

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    2017-06-17 184****9840

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