Anesthesiology:加巴喷丁不会减少老年手术患者术后谵妄:一项随机临床试验

2017-11-17 雷涓 “罂粟花”微信号

术后疼痛和阿片类药物使用与术后谵妄有关。我们设计了一项单中心,随机,安慰剂对照,平行臂,双盲试验,以确定围手术期加巴喷丁使用是否减少非心脏手术术后谵妄。

背景:术后疼痛和阿片类药物使用与术后谵妄有关。我们设计了一项单中心,随机,安慰剂对照,平行臂,双盲试验,以确定围手术期加巴喷丁使用是否减少非心脏手术术后谵妄。

方  法:患者被随机分配术前和术后最初3天内接受安慰剂(N = 347)或加巴喷丁900 mg(N = 350)。主要结果是通过混淆评定法测量的术后谵妄。次要结果是术后疼痛,阿片类药物使用和住院时间。

结  果:纳入697例患者的资料,平均年龄为72±6岁。术后3天谵妄总发生率为22.4%(加巴喷丁组为24.0%,安慰剂组为20.8%,差异为3.20%,95%CI为3.22%?9.72%,P = 0.30) 。根据手术类型,麻醉类型或手术前风险状况分层后,谵妄的发生率没有差异。加巴喷丁显示可节省阿片类药物,干预组与对照组相比阿片类药物剂量更低。例如,加巴喷丁治疗组吗啡用量的中位数6.7mg(第25位,第75位四分位数:1.3mg,20.0mg),而对照组中位数6.7mg(第25位,第75位四分位数:2.7mg,24.8mg)术后第一天有差异(P = 0.04)。

结  论:虽然术后阿片类药物使用减少,但围术期给予加巴喷丁并不能减少术后谵妄或住院时间。

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    2017-12-29 hb2008ye
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    2017-11-19 skhzy

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