中国临床药学杂志2025，Vol.34Issue(3)：209-216,8.DOI:10.19577/j.1007-4406.2025.03.009
全凭静脉麻醉下胸腔镜肺癌根治术老年患者γ-氨基丁酸水平与术后躁动的相关性
Relationship between changes in serum γ-aminobutyric acid levels and postoperative agitation in elderly patients undergoing thoracoscopic radical lung cancer surgery under total intravenous anesthesia
张冬阳 1马良 1周敏 1张惠 1刘国 1汪亚宏1
作者信息
- 1. 昆明医科大学第三附属医院麻醉手术科,昆明 650118
- 折叠
摘要
Abstract
AIM To investigate the relationship between the change of serum γ-aminobutyric acid(GABA)level and agitation in elderly patients after radical lung cancer surgery under total intravenous anesthesia(TIVA).METHODS A total of 607 elderly patients with lung cancer who received radical lung cancer surgery from March 2021 to September 2023 were selected as the study objects.Changes in serum GABA levels before and after surgery were compared,and the correlation between GABA levels and agitation after radical lung cancer surgery was analyzed.The patients were then divided into restless group(n=83)and non-restless group(n=524)according to the occurrence of postoperative agitation.The influencing factors of agitation after radical lung cancer surgery in the elderly patients under TIVA analgesia were analyzed,and a logistic regression model for predicting postoperative agitation was constructed and verified.RESULTS Serum GABA levels differed significantly(P＜0.001)when measured preoperatively and at 10 min and 1 h postoperatively.The serum GABA level of patients 10 min after surgery was significantly higher than that before anesthesia,followed by a marked decline 1 hour after surgery(P＜0.001).It was found that there were statistically significant age differences,time to recovery,blood loss,smoking history,alcohol consumption history and visual analogue scale(VAS)scores among 5 groups(P＜0.05).After gradually excluding confounding factors,GABA level was independently correlated with postoperative agitation(OR=2.46,95％CI:1.40-3.77).Moreover,a statistically significant increasing trend in the risk of postoperative agitation with rising GABA levels was observed(P＜0.01).Subgroup analysis of GABA levels and agitation after radical lung cancer surgery showed that the correlation between GABA level and postoperative agitation was more obvious in patients with VAS scores≥5(OR=4.55,95％CI:2.76-8.85,P＜0.05).Logistic regression analysis showed that age,preoperative anxiety,VAS score and GABA level were independent risk factors for agitation after radical lung cancer surgery in the elderly patients under TIVA analgesia(P＜0.05).A logistic regression model was established,and the highest Yoden index was 0.79,and the corresponding sensitivity was 94.5％.The specificity was 84.7％and the accuracy was 89.6％.It was verified that the model exhibited consistent performance and possessed good prediction effectiveness.CONCLUSION There is still an independent correlation between serum GABA level and postoperative agitation,and increased GABA levels are positively correlated with the incidence of postoperative agitation in elderly patients undergoing thoracoscopic radical lung cancer surgery under TIVA.There is an interaction among the serum GABA level,VAS score and postoperative agitation.Age,preoperative anxiety,VAS score and serum GABA level are independent risk factors for agitation after radical lung cancer surgery in elderly patients under TIVA analgesia.关键词
γ-氨基丁酸/全凭静脉麻醉/老年/肺癌根治手术/躁动Key words
γ-aminobutyric acid/total intravenous anesthesia/elderly patients/radical surgery for lung cancer/postoperative agitation分类
药学引用本文复制引用
张冬阳,马良,周敏,张惠,刘国,汪亚宏..全凭静脉麻醉下胸腔镜肺癌根治术老年患者γ-氨基丁酸水平与术后躁动的相关性[J].中国临床药学杂志,2025,34(3):209-216,8.
