Department of Anesthesia and Intensive Care, San Carlo Clinic, Via Dell'Ospedale, 2, 20030, Paderno Dugnano, Milan, Italy.
Department of Anesthesia and Intensive Care, IRCCS-Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
J Anesth. 2023 Apr;37(2):294-310. doi: 10.1007/s00540-023-03170-y. Epub 2023 Feb 14.
The incidence of postoperative delirium in patients undergoing cardiac surgery is very high and increases morbidity and mortality. The possibility of pharmacological means to reduce its incidence is very attractive. At present, there is still no clear demonstration that any drug can prevent postoperative delirium in these patients. The aim of this Bayesian network meta-analysis (NMA) was to evaluate whether there is evidence that a drug is effective in reducing the incidence of POD in cardiac surgical patients. Our NMA showed that preoperative ketamine at subanesthetic doses can significantly reduce the incidence of POD. Risperidone also decreases the incidence of POD, but not significantly.
心脏手术后发生术后谵妄的发生率非常高,增加了发病率和死亡率。用药物手段降低其发生率的可能性非常有吸引力。目前,还没有明确的证据表明任何药物可以预防这些患者的术后谵妄。本贝叶斯网络荟萃分析(NMA)的目的是评估是否有证据表明某种药物可有效降低心脏手术患者 POD 的发生率。我们的 NMA 表明,亚麻醉剂量的术前氯胺酮可显著降低 POD 的发生率。利培酮也可降低 POD 的发生率,但不显著。