Wang Lu, Yi Qiong, Ye Chunyan, Luo Ning, Wang E
Department of Anesthesiology, Xiangya Hospital Central South University, Changsha 410008, China.
National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha 410008, China.
J Pers Med. 2023 Mar 28;13(4):590. doi: 10.3390/jpm13040590.
In China, dezocine is commonly employed as a partial agonist of mu/kappa opioid receptors during anesthesia induction for surgical patients, yet evidence supporting its causal association with emergence delirium is limited. The objective of this investigation was to evaluate the impact of intravenous dezocine administered during anesthesia induction on emergence delirium. The retrospective studied existing data containing medical records of patients undergoing an elective laparoscopy procedure and the study was conducted with ethics-board approval. The primary outcome was the incidence of emergence delirium. Secondary outcomes included the VAS in the PACU and 24 h after surgery, the RASS score in the PACU, postoperative MMSE, hospital stay, and ICU stay. A total of 681 patients were analyzed, after being propensity score-matched, the dezocine and non-dezocine group each had 245 patients. Emergence delirium occurred in 26/245 (10.6%) of patients who received dezocine and 41/245 (16.7%) of patients did not receive dezocine. Patients on whom dezocine was used were associated with a significantly lower incidence of emergence delirium (absolute risk difference, -6.1%, 95% CI, -12% to -0.2%; relative risk [RR], 0.63; 95% CI, 0.18-0.74). All secondary outcome measures and adverse outcomes were not significantly different. The use of dezocine during anesthesia induction was associated with a decreased incidence of emergence delirium after elective laparoscopic surgeries.
在中国,地佐辛通常在外科手术患者麻醉诱导期间用作μ/κ阿片受体的部分激动剂,但支持其与苏醒期谵妄存在因果关系的证据有限。本研究的目的是评估麻醉诱导期间静脉注射地佐辛对苏醒期谵妄的影响。这项回顾性研究分析了接受择期腹腔镜手术患者的病历数据,该研究经伦理委员会批准。主要结局是苏醒期谵妄的发生率。次要结局包括麻醉后恢复室(PACU)及术后24小时的视觉模拟评分(VAS)、PACU中的Richmond躁动镇静评分(RASS)、术后简易精神状态检查表(MMSE)、住院时间和重症监护病房(ICU)住院时间。共分析了681例患者,经倾向得分匹配后,地佐辛组和非地佐辛组各有245例患者。接受地佐辛治疗的患者中有26/245(10.6%)发生苏醒期谵妄,未接受地佐辛治疗的患者中有41/245(16.7%)发生苏醒期谵妄。使用地佐辛的患者苏醒期谵妄发生率显著较低(绝对风险差异为-6.1%,95%置信区间为-12%至-0.2%;相对风险[RR]为0.63;95%置信区间为0.18 - 0.74)。所有次要结局指标和不良结局均无显著差异。择期腹腔镜手术后麻醉诱导期间使用地佐辛与苏醒期谵妄发生率降低有关。