戊乙奎醚对老年患者术后谵妄的影响

Effect of penehyclidine on postoperative delirium of elder patients underwent total hip replacement

目的观察戊乙奎醚作为术前用药对老年患者术后谵妄的影响。方法99例髋关节置换的老年患者随机分为四组,术前分别予静注戊乙奎醚4.6μg/kg(A组)、9.1μg/kg(B组)、13.7μg/kg(C组)和生理盐水(D组),术后4d内评估患者是否发生谵妄。结果患者一般资料、芬太尼用量、术中病情和术后疼痛VAS评分组间无明显区别(P>0.05)。B和C组的术后谵妄发生率分别为26.9%和25.0%,明显高于A组的16.0%和D组的15.0%(P<0.05)。结论术前戊乙奎醚用量偏大可能会增加老年患者术后谵妄发生率。

Objective To observe the influence of penehyclidine in different doses used before general anesthesia on postoperative delirium of elder patients underwent total hip replacement（THR）. Methods Ninety-nine elder patients were randomly divided into four groups. Penehyclidine as a premedication was intravenously injected in a dose of 4.6μg/kg in group A（26 cases）, 9.1μg/kg in group B （25 cases）, or 13.7μg/kg in group C（28 cases）. The patients in group D（20 cases） were given normal saline as the controls. Postoperative pain scores and morbidity of delirium in 4 days were recorded. Results There was no significant difference in general conditions among four groups. The morbidity of delirium was 26.9% in group B and 25.0% in group C, which were significantly higher than 16.0% in group A and 15.0% in group D （P〈0.05）. Conclusion Higher dose of penehyclidine as a premedication may increase the incidence of postoperative delirium in elder patients.