围手术期谵妄的最新进展。

Update on Perioperative Delirium.

机构信息

Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road L459, Portland, OR 97239, USA.

Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, 2000 S Bayshore Drive Apartment 51, Miami, FL 33133, USA.

出版信息

Anesthesiol Clin. 2023 Sep;41(3):567-581. doi: 10.1016/j.anclin.2023.02.007. Epub 2023 May 22.

DOI:10.1016/j.anclin.2023.02.007

PMID:37516495

Abstract

A strong association between frailty and in-hospital delirium in nonsurgical patients has been shown. Physical and cognitive frailties have been associated with decline and dysfunction in the frontal cognitive domains. Risk factors for frailty are similar to risk factors for postoperative delirium (POD). Frailty can be screened and diagnosed by various tools and instruments. Different anesthetic techniques have been studied to decrease the incidence of POD. However, no anesthetic technique has been conclusively proven to decrease the risk of POD. Patients with dementia develop delirium more often, and delirium is associated with accelerated cognitive decline.

摘要

已经证明，非手术患者的虚弱与住院期间的谵妄之间存在很强的关联。身体和认知方面的虚弱与额叶认知领域的衰退和功能障碍有关。衰弱的危险因素与术后谵妄（POD）的危险因素相似。可以使用各种工具和仪器来筛查和诊断衰弱。已经研究了不同的麻醉技术来降低 POD 的发生率。然而，没有一种麻醉技术被确凿地证明可以降低 POD 的风险。患有痴呆症的患者更容易发生谵妄，而且谵妄与认知能力加速下降有关。