麻醉安全与质控2025，Vol.7Issue(4)：305-309,5.DOI:10.3969/j.issn.2096-2681.2025.04.007
艾司氯胺酮对老年髋部骨折患者术后谵妄的影响
Effect of esketamine on postoperative delirium in elderly patients undergoing hip fracture surgery
摘要
Abstract
Objective To investigate the effect of esketamine on postoperative delirium(POD)in elderly patients undergoing surgery for hip fracture.Methods A total of 100 patients,including 32 males and 68 females,aged 65-95 years,with body mass index(BMI)18.0-27.9 kg/m2,of American Society of Anesthesiologists(ASA)Physical Status classification Ⅰ-Ⅲ,scheduled for hip fracture surgery under general anesthesia,from October 2024 to March 2025 were selected and randomly divided into the control group(group C,n=50)and the esketamine group(group E,n=50).After tracheal intubation,group E received continuous infusion of esketamine at a rate of 0.3 mg/(kg·h)intraoperatively until the beginning of skin incision closure.Group C received equivalent volumes and rates of 0.9％normal saline;the injection methods were in accordance with those in group E.The dosages of propofol and remifentanil were re-corded during surgery.The incidence of POD in three days after surgery were evaluated using the confusion assessment method.Postoper-ative pain scores at rest using the numeric rating scale(NRS)were recorded at 24,48,and 72 h postoperatively,and the rate of rescue analgesia was recorded.The incidence of adverse events including nausea,vomiting,dizziness,hallucinations,and nightmares,were re-corded in three days after surgery.30-day all-cause mortality was recorded.Results Compared with group C,the incidence of POD was lower in group E(12％ vs 30％,P=0.027),along with the decreasing dosage of remifentanil(1153.9±120.2 μg vs 1210.2±116.1 μg,P=0.019),and the NRS score at rest significantly decreased at 24,48 h after surgery(P＜0.05).Conclusion Esketamine could reduce the incidence of POD and postoperative pain,and would not increase the risk of adverse effects in elderly patients undergoing hip fracture surgery.关键词
艾司氯胺酮/术后谵妄/髋部骨折/老年患者Key words
esketamine/postoperative delirium/hip fracture/elderly patients引用本文复制引用
邵长会,黄维艳,陆艳萍,张董瑜,冯琪,汤雪夫,欧珊..艾司氯胺酮对老年髋部骨折患者术后谵妄的影响[J].麻醉安全与质控,2025,7(4):305-309,5.基金项目
成都市卫生健康委2023年成都市医学科研课题(2023118) （2023118）
