Nguyen Son, Pak Mila, Paoli Daniel, Neff Donna F
Orlando VA Medical Center, UCF College of Medicine.
Anesthesiology, Orlando VA Medical Center ; Courtesy Professor, UCF College of Nursing.
Cureus. 2016 Dec 8;8(12):e921. doi: 10.7759/cureus.921.
The clinical characteristics of emergence delirium (ED) associated with post-traumatic stress disorder (PTSD) among military veterans encompass transient agitation, restlessness, disorientation, and violent verbal and physical behaviors due to re-experiencing of PTSD-related incidents. Two cases of ED after general anesthesia associated with PTSD are presented. Different anesthesia methods were applied for the two cases. A traditional medical approach appeared not to prevent the incidence of ED. In the second case, dexmedetomidine infusion along with verbal coaching was effective in preventing ED for a veteran known to have "wild wake-ups" with prior anesthetics. Further clinical studies in effectively utilizing dexmedetomidine in this population with PTSD at high risk for ED are warranted.
退伍军人中与创伤后应激障碍（PTSD）相关的苏醒期谵妄（ED）的临床特征包括因再次经历与PTSD相关的事件而出现的短暂激动、烦躁不安、定向障碍以及暴力言语和身体行为。本文介绍了2例全身麻醉后与PTSD相关的ED病例。两例采用了不同的麻醉方法。传统医学方法似乎无法预防ED的发生。在第二例中，对于一名已知既往麻醉后会出现“疯狂苏醒”的退伍军人，输注右美托咪定并辅以言语指导有效地预防了ED。有必要对在这一高风险发生ED的PTSD人群中有效使用右美托咪定进行进一步的临床研究。
