艾司氯胺酮主导无阿片麻醉对老年患者全髋关节置换术术后谵妄的影响被引量：2

Effects of esketamine-mediated opioid-free anesthesia on delirium in elderly patients after hip replacement

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摘要目的:观察以艾司氯胺酮为主的无阿片麻醉对老年患者全髋关节置换术术后谵妄(postop‐erativedelirium,POD)的影响。方法:择期行全髋关节置换术(totalhiparthroplasty,THA)的老年患者114例,随机分为无阿片麻醉(OFA)组和阿片麻醉(OA)组(n=57)。OFA组:采用以艾司氯胺酮为主的无阿片麻醉方案;OA组采用以舒芬太尼和瑞芬太尼为主的常规阿片麻醉方案。主要记录术后3天内谵妄发生情况,采用中文修订版谵妄诊断量表(CAM-CR)对患者的谵妄状态进行评估。结果:OFA组相较于OA组术后2天的CAM-CR评分以及谵妄发生率均较低。结论:以艾司氯胺酮为主的无阿片麻醉可有效降低老年患者全髋关节置换术术后谵妄的发生。 AIM:To observe the effect of opioid-free anesthesia with esketamine on delirium after hip replacement surgery in elderly patients.METHODS:One hundred and fourteen elderly patients who underwent hip replacement were randomly divided into two groups:opioid-free anesthesia(OFA)group and opioid anesthesia(OA)group(n=57).During anesthesia induction and maintenance,esketamine was administered in OFA group,and that fentanyl and remifentanil were administered in OA group.Delirium was mainly recorded within 3 days after the surgeries,and the patients'delirium status was evaluated using the Chinese Revised Delirium Diagnostic Scale(CAM-CR).RESULTS:The patients in OFA group had lower CAM-CR scores and delirium incidence compared to those in the OA group at 2 days after surgery.CONCLUSION:Opioid-free anesthesia based on esketamine can effectively reduce delirium after hip replacement in elderly patients.

作者华豪何滕李鑫陈晓东刘祯庆刘坤张琪姜琳刘存明王猛杨春 HUA Hao;HE Teng;LI Xin;CHEN Xiaodong;LIU Zhenqing;LIU Kun;ZHANG Qi;JIANG Lin;LIU Cunming;WANG Meng;YANG Chun(Department of Anesthesiology,Wuxi 9th People's Hospital Affiliated to Soochow University,Wuxi 214062,Jiangsu,China;Department of Anesthesiology and Perioperative Medicine,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China;Department of Anesthesiology,Taizhou People's Hospital Affiliated Hospital of Nanjing Medical University,Taizhou 225300,Jiangsu,China)

机构地区苏州大学附属无锡九院麻醉科南京医科大学第一附属医院麻醉与围术期医学科南京医科大学附属泰州市人民医院麻醉科

出处《中国临床药理学与治疗学》北大核心 2025年第1期78-84,共7页 Chinese Journal of Clinical Pharmacology and Therapeutics

基金国家自然科学基金(82271254,82371202,82301444) 江苏省双创团队领军人才项目(JSSCTD202144) 江苏省无锡市卫健委重大项目(Z202218) 江苏省无锡市卫健委面上项目(M202337) 南京医科大学泰州临床医学院重点项目(TZKY20220311)。

关键词艾司氯胺酮无阿片麻醉老年患者谵妄镇痛 esketamine opioid-free anesthesia elderly patients delirium analgesia

分类号 R614 [医药卫生—麻醉学]

作者简介华豪,男,医学硕士,副主任医师,研究方向:临床麻醉与疼痛诊疗;共同第一作者:何滕,男,医学硕士,主治医师,研究方向:麻醉药物毒理学;通信作者:王猛,男,医学博士,主任医师,硕士生导师,研究方向:临床麻醉与镇痛。E-mail:wxfy2071@163.com;共同通信作者:杨春,男,医学博士,教授/副主任医师,博士生导师,研究方向:麻醉机制与脑科学。E-mail:chunyang@njmu.edu.cn。