摘要
目的评价不同剂量盐酸戊乙奎醚对老年患者非全麻手术后早期认知功能的影响。方法检索老年患者非全麻手术前使用盐酸戊乙奎醚的临床随机对照研究(RCTs),根据Cochrane 5.1手册要求,分别选择研究、提取数据并评价纳入RCTs的质量,使用Rev Man 5.3软件进行Meta分析。结果纳入8项研究,共554例患者。结果显示,非全麻手术前应用盐酸戊乙奎醚,术后认知功能障碍(POCD)发生率明显升高,但与阿托品、东莨菪碱等相似;相比对照组,盐酸戊乙奎醚分别予以静脉注射给药和肌内注射给药,POCD发生率差异无统计学意义;盐酸戊乙奎醚0.5 mg及以下剂量POCD发生率与对照组相比,差异无统计学意义,但0.5mg以上剂量POCD发生率明显升高。与对照组、生理盐水组比较,盐酸戊乙奎醚对ΔMMSE评分影响明显,但与阿托品类似。结论根据评价,非全麻手术前静脉注射或肌内注射0.5 mg及以下盐酸戊乙奎醚可能对老年患者早期认知影响较小,但是仍需采用设计更多、良好、大规模、多中心的临床RCTs来验证。
AIM To evaluate the effects of different doses of penehyclidine hydrochloride on early cognitive function in elderly patients after non general anesthesia.METHODS The clinical randomized controlled trials(RCTs)of penehyclidine hydrochloride in elderly patients before non-general anesthesia were retrieved.According to the requirements of Cochrane 5.1 manual,the studies were selected,the data were extracted and the quality of RCTs was evaluated,and the Revman 5.3 software was used for Meta-analysis.RESULTS Eight studies with 554 patients were included.The results showed that the incidence of postoperative cognitive dysfunction(POCD)was significantly increased by using penehyclidine hydrochloride before non-general anesthesia,but it was similar to atropine and scopolamine.Compared with the control group,there was no significant difference in the incidence of POCD when penehyclidine hydrochloride was administered intravenously and intramuscularly.Compared with the control group,there was no significant difference in the incidence of POCD at the dose of penehyclidine hydrochloride 0.5 mg and below,but the incidence of POCD increased significantly at the dose of 0.5 mg or above.Compared with the control group and normal saline group,penehyclidine hydrochloride had a significant effect onΔMMSE score,but it was similar to atropine.CONCLUSION According to this evaluation,intravenous or intramuscular injection of penehyclidine hydrochloride 0.5 mg or less before non-general anesthesia may have little effect on the early cognition of elderly patients,but it still needs to be verified by more,well-designed,large-scale and multicenter clinical RCTs.
作者
徐锦龙
马卫成
段宝忠
王井玲
XU Jinlong;MA Weicheng;DUAN Baozhong;WANG Jingling(Pharmacy Department,Ningbo Yinzhou Second Hospital,Ningbo 315100,China;College of Pharmaceutical Science,Dali University,Dali 671003,China)
出处
《中国临床药学杂志》
CAS
2022年第7期517-522,共6页
Chinese Journal of Clinical Pharmacy
基金
国家自然科学基金(编号31860080)
浙江省药学会医院药学专项基金项目(编号2018ZYY38)
关键词
盐酸戊乙奎醚
老年患者
非全麻手术
认知功能
penehyclidine hydrochloride
elderly patient
non-general anesthesia
cognitive function
