雷马唑仑对预防股骨近端骨折老年患者术后谵妄的效果。

IF 2.8 3区 医学 Q2 ANESTHESIOLOGY
Journal of Anesthesia Pub Date : 2024-08-01 Epub Date: 2024-03-26 DOI:10.1007/s00540-024-03339-z
Daichi Fujimoto, Norihiko Obata, Satoshi Mizobuchi
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引用次数: 0

摘要

目的:众所周知,股骨近端骨折的老年患者是术后谵妄(POD)的高危人群。本研究旨在确定苯二氮卓类药物雷米马唑仑与股骨近端骨折老年患者术后谵妄的相关性:在这项单中心回顾性观察研究中,我们纳入了因股骨近端骨折而接受全身麻醉的 65 岁或以上患者。我们收集了术后 3 天内 POD 发生率的数据。我们还收集了并发症、术前血液检查、麻醉维持和术中生命体征数据。我们将接受雷马唑仑全身麻醉的患者(雷马唑仑组)与接受其他麻醉剂全身麻醉的患者(其他组)的 POD 发生率进行了比较。最后,我们进行了多变量分析,以评估雷马唑仑与 POD 风险的独立关联:本研究共纳入 230 例患者,其中包括 54 例接受雷马唑仑维持麻醉的患者。患者的 POD 发生率为 26.1%。术后 3 天内谵妄的发生率,雷马唑仑组明显低于其他组(14.8% 对 29.5%,P = 0.03)。多变量分析显示,使用雷马唑仑可独立降低POD的发生率(调整后的几率=0.42,P=0.04):这项回顾性观察研究表明,使用雷马唑仑可降低 POD 的发生率。在老年股骨近端骨折患者中,可以考虑使用雷马唑仑来减少POD的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Effectiveness of remimazolam in preventing postoperative delirium in elderly patients with proximal femoral fractures.

Effectiveness of remimazolam in preventing postoperative delirium in elderly patients with proximal femoral fractures.

Purpose: Elderly patients with proximal femoral fractures are known to be a high-risk group for postoperative delirium (POD). The aim of this study was to determine the association of the benzodiazepine drug remimazolam with POD in elderly patients with proximal femoral fractures.

Methods: In this single-center retrospective observational study, we included patients aged 65 years or older who underwent general anesthesia for proximal femoral fractures. We collected data for the incidence of POD within 3 days after surgery. We also obtained data for complications, preoperative blood examinations, maintenance anesthetic and intraoperative vital data. The occurrence of POD in patients who received remimazolam for general anesthesia (remimazolam group) was compared to that in patients who received general anesthesia with other anesthetic agents (other group). We finally conducted a multivariate analysis to assess the independent association of remimazolam with the risk of POD.

Results: A total of 230 patients, including 54 patients who received remimazolam for maintenance anesthesia, were included in this study. The incidence of POD in the patients was 26.1%. The incidence of delirium within 3 days after surgery was significantly lower in the remimazolam group than in the other group (14.8% vs. 29.5%, p  =  0.03). The multivariate analysis showed that the use of remimazolam independently reduced the occurrence of POD (adjusted odds ratio  =  0.42, p  =  0.04).

Conclusion: This retrospective observational study showed that the use of remimazolam is independently associated with a reduced incidence of POD. Remimazolam may be considered as an option to reduce POD in elderly patients with proximal femoral fractures.

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来源期刊
Journal of Anesthesia
Journal of Anesthesia 医学-麻醉学
CiteScore
5.30
自引率
7.10%
发文量
112
审稿时长
3-8 weeks
期刊介绍: The Journal of Anesthesia is the official journal of the Japanese Society of Anesthesiologists. This journal publishes original articles, review articles, special articles, clinical reports, short communications, letters to the editor, and book and multimedia reviews. The editors welcome the submission of manuscripts devoted to anesthesia and related topics from any country of the world. Membership in the Society is not a prerequisite. The Journal of Anesthesia (JA) welcomes case reports that show unique cases in perioperative medicine, intensive care, emergency medicine, and pain management.
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