Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Medicine (Baltimore). 2022 Dec 30;101(52):e32562. doi: 10.1097/MD.0000000000032562.
To investigate the effect of preoperative tropisetron treatment on postoperative cognitive function on the basis of patients' Mini-Cog scale scores. In this retrospective cohort study, data were retrieved from the medical record database. This research did not involve concerns with patient safety and violation of their interests, and therefore, no ethical review was required. Depending on tropisetron exposure status, patients were assigned to the exposure group (86 patients) and the non-exposure group (74 patients). Patients in the exposure and non-exposure groups were administered tropisetron (10 mg; intravenously 15 minutes before operation) and other antiemetics, respectively. Data on the patients' demographic characteristics, American society of Anesthesiologists (ASA) classification, comorbid underlying diseases, sleep quality, education level, anesthesia method, duration of fasting, intraoperative blood loss and fluid replacement, intraoperative minimum and maximum systolic blood pressures (SBPs), intraoperative minimum and maximum diastolic blood pressures (DBPs), postoperative Mini-Cog scale (a simple intelligence status assessment scale) score, and postoperative visual analogue scale (VAS) pain score were collected in both the groups. The postoperative Mini-Cog score (as an indicator of cognitive function) and the rate of postoperative cognitive impairment were compared between the exposure and non-exposure groups. A multifactorial logistic regression equation was constructed to analyze the factors associated with impaired cognitive function in the postoperative period. The postoperative cognitive impairment rate in the exposure group was significantly lower than that in the non-exposure group (3.5% vs 16.2%; P < .05). Multifactorial logistic regression analysis suggested that tropisetron was a protective factor for postoperative cognitive function, with a statistically significant effect (odds ratio [OR] = 5.04, 95% confidence interval [CI] = 1.31-19.4). Preoperative tropisetron exposure significantly reduces the incidence of postoperative cognitive impairment in patients, and it is a protective factor for postoperative cognitive function.
为了根据患者的 Mini-Cog 量表评分,研究术前托烷司琼治疗对术后认知功能的影响。在这项回顾性队列研究中,从病历数据库中检索数据。本研究不涉及患者安全问题和对其利益的侵犯,因此无需进行伦理审查。根据托烷司琼暴露状态,将患者分为暴露组(86 例)和非暴露组(74 例)。暴露组和非暴露组患者分别给予托烷司琼(10mg;术前 15 分钟静脉注射)和其他止吐药。收集两组患者的人口统计学特征、美国麻醉医师协会(ASA)分级、合并基础疾病、睡眠质量、教育水平、麻醉方法、禁食时间、术中失血量和液体替代量、术中收缩压(SBP)最小值和最大值、术中舒张压(DBP)最小值和最大值、术后 Mini-Cog 量表评分(一种简单的智力状态评估量表)和术后视觉模拟量表(VAS)疼痛评分。比较暴露组和非暴露组术后 Mini-Cog 评分(认知功能指标)和术后认知障碍发生率。构建多因素逻辑回归方程分析术后认知功能障碍的相关因素。暴露组术后认知障碍发生率明显低于非暴露组(3.5%比 16.2%;P<0.05)。多因素逻辑回归分析表明,托烷司琼是术后认知功能的保护因素,具有统计学意义(比值比[OR] = 5.04,95%置信区间[CI] = 1.31-19.4)。术前托烷司琼暴露可显著降低患者术后认知障碍发生率,是术后认知功能的保护因素。