静脉患者自控镇痛对骨科手术患者谵妄预后有积极影响。
Intravenous Patient-controlled Analgesia Has a Positive Effect on the Prognosis of Delirium in Patients Undergoing Orthopedic Surgery.
机构信息
Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, Korea.
出版信息
Korean J Pain. 2014 Jul;27(3):271-7. doi: 10.3344/kjp.2014.27.3.271. Epub 2014 Jun 30.
BACKGROUND
Postoperative delirium is relatively common. However, the relationship between intravenous patient-controlled analgesia (IV-PCA) and delirium has not been thoroughly investigated. The aim of this study was to evaluate the effects of IV-PCA on the prognosis of postoperative delirium in patients undergoing orthopedic surgery.
METHODS
Medical records of 129 patients with postoperative delirium were reviewed. Patients were divided into two groups according to whether they used IV-PCA with fentanyl and ketorolac. The IV-PCA group consisted of 73 patients who were managed with IV-PCA; the NO-PCA group consisted of 56 patients who were managed without PCA.
RESULTS
Incidences of multiple psychiatric consultations and prolonged delirium were significantly lower in patients using IV-PCA with fentanyl and ketorolac than in those without PCA.
CONCLUSIONS
We recommend the use of IV-PCA for pain control and management of delirium in patients with postoperative delirium.
背景
术后谵妄较为常见。然而，静脉患者自控镇痛（IV-PCA）与谵妄之间的关系尚未得到充分研究。本研究旨在评估 IV-PCA 对骨科手术后术后谵妄患者预后的影响。
方法
回顾了 129 例术后谵妄患者的病历。根据是否使用芬太尼和酮咯酸的 IV-PCA，将患者分为两组。IV-PCA 组 73 例，采用 IV-PCA 治疗；无 PCA 组 56 例，采用常规治疗。
结果
使用芬太尼和酮咯酸的 IV-PCA 组患者的多次精神科会诊和持续时间较长的谵妄发生率明显低于未使用 PCA 的患者。
结论
我们建议在术后谵妄患者中使用 IV-PCA 进行疼痛控制和谵妄管理。
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