PDF(Pubmed)
Abstract：
In addition to stabilizing blood pressure (BP), ephedrine and phenylephrine have distinct effects on regional cerebral oxygen saturation (rSO2). However, whether its effect on rSO2 affects the occurrence of postoperative delirium (POD) remains unclear. Therefore, the aim of this study is to compare the effects of ephedrine and phenylephrine for BP maintenance on the incidence of POD in olderly adults who underwent knee arthroplasty under general anesthesia. One hundred twenty patients who were between 60 and 90 years old and underwent knee arthroplasty were included in this study. The patients were randomly divided into two groups: the ephedrine group and the phenylephrine group. After anesthesia induction, ephedrine and phenylephrine were continuously infused to maintain the intraoperative mean arterial pressure within the normal range (baseline mean arterial pressure ± 20%). The primary outcome measures included the incidence of POD within 1-3 days after surgery. The incidence of POD on the first day after surgery was lower in the ephedrine group than in the phenylephrine group (33% vs. 7%, P < 0.001). However, there was no significant difference in the incidence of POD between the two groups on the second and third postoperative days. Compared with the phenylephrine group, the ephedrine group experienced significantly greater cardiac output (CO) and rSO2 (P < 0.05).Clinical Trials Registry: ChiCTR2200064849, principal investigator: Changjian Zheng.
摘要：
除了稳定血压（BP），麻黄碱和去氧肾上腺素对局部脑氧饱和度（rSO2）有明显影响。然而,其对rSO2的影响是否会影响术后谵妄（POD）的发生尚不清楚。因此,这项研究的目的是比较麻黄碱和去氧肾上腺素维持血压对全身麻醉下接受膝关节置换术的老年人POD发生率的影响。这项研究包括了120名年龄在60至90岁之间并接受了膝关节置换术的患者。将患者随机分为两组：麻黄碱组和去氧肾上腺素组。麻醉诱导后,持续输注麻黄碱和去氧肾上腺素以维持术中平均动脉压在正常范围内(基线平均动脉压±20%).主要结果指标包括手术后1-3天内POD的发生率。麻黄碱组术后第一天POD的发生率低于去氧肾上腺素组(33%vs.7%,P<0.001)。然而,两组术后第2天和第3天的POD发生率无显著差异.与去氧肾上腺素组相比，麻黄碱组的心输出量(CO)和rSO2显著增加(P<0.05)。临床试验注册：ChiCTR2200064849，主要研究者：郑昌健。
