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氟哌啶醇在老年患者围手术期中的应用对术后谵妄的影响：系统评价和荟萃分析。

The effect of haloperidol's perioperative application on postoperative delirium in elderly patients: a systematic review and meta-analysis.

机构信息

Department of Anaesthesiology, Hebei General Hospital, Shijiazhuang, 050051, China.

Department of Gynaecology, Hebei General Hospital, Shijiazhuang, 050051, China.

出版信息

BMC Anesthesiol. 2024 Feb 3;24(1):49. doi: 10.1186/s12871-024-02434-8.

DOI:10.1186/s12871-024-02434-8
PMID:38308229
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10837937/
Abstract

OBJECTIVES

To systematically review the evidence about the effect of haloperidol on postoperative delirium in elderly patients.

METHODS

PubMed, Embase, the Cochrane Library and China National Knowledge Infrastructure were used to find concerned studies for meta-analysis. The main outcome was the incidence of postoperative delirium, and the secondary outcomes were side effects of haloperidol and the length of hospital stay. The meta-analyses were conducted using the Review Manager Version 5.1. This study was conducted based on the PRISMA statement.

RESULTS

Eight RCTs (1569 patients) were included in the meta-analysis. There was a significant difference in the incidence of postoperative delirium between haloperidol and control groups (OR = 0.62, 95%CI 0.48-0.80, P = 0.0002, I = 20%). In addition, side effects of haloperidol and the duration of hospitalization were comparable (OR = 0.58, 95%CI 0.25-1.35, P = 0.21, I = 0%; MD =-0.01, 95%CI -0.16-0.15, P = 0.92, I = 28%). Subgroup analysis implied the effect of haloperidol on postoperative delirium might vary with the dose (5 mg daily: OR = 0.40, 95%CI 0.22-0.71, P = 0.002, I = 0%; <5 mg daily: OR = 0.72, 95%CI 0.42-1.23, P = 0.23, I = 0%).

CONCLUSIONS

The meta-analysis revealed perioperative application of haloperidol could decrease the occurrence of postoperative delirium without obvious side effects in elderly people, and high-dose haloperidol (5 mg daily) possessed a greater positive effect.

摘要

目的

系统评价氟哌啶醇对老年患者术后谵妄的影响。

方法

检索 PubMed、Embase、Cochrane 图书馆和中国知网，以进行荟萃分析。主要结局是术后谵妄的发生率，次要结局是氟哌啶醇的副作用和住院时间。采用 Review Manager Version 5.1 进行荟萃分析。本研究基于 PRISMA 声明进行。

结果

纳入 8 项 RCT（1569 例患者）进行荟萃分析。氟哌啶醇组与对照组术后谵妄发生率差异有统计学意义（OR=0.62，95%CI 0.48-0.80，P=0.0002，I²=20%）。此外，氟哌啶醇的副作用和住院时间相当（OR=0.58，95%CI 0.25-1.35，P=0.21，I²=0%；MD=-0.01，95%CI -0.16-0.15，P=0.92，I²=28%）。亚组分析表明，氟哌啶醇对术后谵妄的影响可能与剂量有关（5mg/d：OR=0.40，95%CI 0.22-0.71，P=0.002，I²=0%；<5mg/d：OR=0.72，95%CI 0.42-1.23，P=0.23，I²=0%）。

结论

荟萃分析表明，围手术期应用氟哌啶醇可降低老年患者术后谵妄的发生率，且无明显副作用，高剂量氟哌啶醇（5mg/d）效果更为显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/25a78e57d1db/12871_2024_2434_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/af2277c7b635/12871_2024_2434_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/cb87be4aeae0/12871_2024_2434_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/a9712c7187df/12871_2024_2434_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/8686a49c1193/12871_2024_2434_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/a6c7e45201d1/12871_2024_2434_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/0763028a999a/12871_2024_2434_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/25a78e57d1db/12871_2024_2434_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/af2277c7b635/12871_2024_2434_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/b71f5e292e1e/12871_2024_2434_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/cb87be4aeae0/12871_2024_2434_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/a9712c7187df/12871_2024_2434_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/8686a49c1193/12871_2024_2434_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/a6c7e45201d1/12871_2024_2434_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/0763028a999a/12871_2024_2434_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/10837937/25a78e57d1db/12871_2024_2434_Fig8_HTML.jpg

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