Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts.
Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts; Department of Orthopedic Surgery, Tufts University Medical Center, Boston, Massachusetts.
J Arthroplasty. 2014 Feb;29(2):268-71. doi: 10.1016/j.arth.2013.06.004. Epub 2013 Jul 5.
Total joint arthroplasty (TJA) patients are at increased risk of post-operative delirium (POD) given their demographics and functional impairment. Certain pharmacologic agents are known to cause delirium, but those that cause delirium following TJA are unknown. Our aim was to explore if specific anesthetic agents, opiate pain medications, or benzodiazepines are associated with POD following TJA. A matched case (n=98)-control (n=365) design and conditional logistic regression model were used to examine risk factors for POD among TJA patients at our institution from 2006 to 2010. The model was adjusted for gender, pre-operative alcohol use, and pre-operative depression. Our data suggest that isoflurane and benzodiazepines are associated with an increased risk of delirium in TJA patients and should be used with caution. Hydromorphone and morphine did not increase the risk of delirium in TJA patients and may be considered for post-operative pain control.
全关节置换术（TJA）患者由于其人口统计学和功能障碍，术后谵妄（POD）的风险增加。已知某些药物会引起谵妄，但 TJA 后引起谵妄的药物尚不清楚。我们的目的是探讨特定的麻醉剂、阿片类止痛药或苯二氮䓬类药物是否与 TJA 后 POD 相关。使用匹配病例（n=98）-对照（n=365）设计和条件逻辑回归模型，检查 2006 年至 2010 年我院 TJA 患者 POD 的危险因素。该模型调整了性别、术前饮酒和术前抑郁。我们的数据表明，异氟烷和苯二氮䓬类药物与 TJA 患者谵妄风险增加相关，应谨慎使用。氢吗啡酮和吗啡不会增加 TJA 患者谵妄的风险，可考虑用于术后疼痛控制。
