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学科主题: 临床医学
题名:
Effects of two different anesthesia-analgesia methods on incidence of postoperative delirium in elderly patients undergoing major thoracic and abdominal surgery: study rationale and protocol for a multicenter randomized controlled trial
作者: Li, Ya-Wei1; Li, Hui-Juan2; Li, Huai-Jin1; Feng, Yi3; Yu, Yao3; Guo, Xiang-Yang4; Li, Yan4; Zhao, Bin-Jiang5; Hu, Xiao-Yun5; Zuo, Ming-Zhang6; Zhang, Hong-Ye6; Wang, Mei-Rong2; Ji, Ping2; Yan, Xiao-Yan2; Wu, Yang-Feng2; Wang, Dong-Xin1
关键词: Aged ; Surgical procedures ; Anesthesia ; Epidural ; Analgesia ; Epidural ; Postoperative complications ; Delirium
刊名: BMC ANESTHESIOLOGY
发表日期: 2015-10-13
DOI: 10.1186/s12871-015-0118-5
卷: 15
收录类别: SCI ; SSCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Anesthesiology
研究领域[WOS]: Anesthesiology
关键词[WOS]: INTENSIVE-CARE-UNIT ; CONFUSION ASSESSMENT METHOD ; CRITICALLY-ILL PATIENTS ; MECHANICALLY VENTILATED PATIENTS ; AGITATION-SEDATION SCALE ; MENTAL-STATE-EXAMINATION ; POPULATION-BASED COHORT ; EPIDURAL-ANESTHESIA ; NONCARDIAC SURGERY ; RISK-FACTORS
英文摘要:

Background: Delirium is a common complication in elderly patients after surgery and associated with increased morbidity and mortality. Studies suggest that deep anesthesia and intense pain are important precipitating factors of postoperative delirium. Neuraxial block is frequently used in combination with general anesthesia for patients undergoing major thoracic and abdominal surgery. Compared with general anesthesia alone and postoperative intravenous analgesia, combined epidural-general anesthesia and postoperative epidural analgesia decreases the requirement of general anesthetics during surgery and provided better pain relief after surgery. However, whether combined epidural-general anesthesia plus epidural analgesia is superior to general anesthesia plus intravenous analgesia in decreasing the incidence of postoperative delirium remains unknown.

Methods/design: This is a multicenter, open-label, randomized, parallel-controlled clinical trial. One thousand eight hundred elderly patients (age range 60-90 years) who are scheduled to undergo major thoracic or abdominal surgery are randomized to receive either general anesthesia plus postoperative intravenous analgesia or combined epidural-general anesthesia plus postoperative epidural analgesia. The primary outcome is the 7-day incidence of postoperative delirium. Secondary outcomes include the duration of postoperative delirium, the intensity of pain during the first three days after surgery, the 30-day incidences of postoperative non-delirium complications, the length of stay in hospital after surgery and 30-day all-cause mortality.

Discussion: Results of the present study will provide information to guide clinical practice in choosing appropriate anesthesia-analgesia method for elderly patients undergoing major thoracic and abdominal surgery.

语种: 英语
所属项目编号: PUCRP201101
项目资助者: Fundamental Research Funds for the Central Universities-Peking University Clinical Research Program in Peking University Health Science Center ; Peking University First Hospital
WOS记录号: WOS:000362535900001
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/50879
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: 1.Peking Univ, Clin Res Inst, Beijing 100191, Peoples R China
2.Beijing Shijitan Hosp, Dept Anesthesiol, Beijing 100038, Peoples R China
3.Beijing Hosp, Dept Anesthesiol, Beijing 100730, Peoples R China
4.Peking Univ, Hosp 1, Dept Anesthesiol & Crit Care Med, Beijing 100034, Peoples R China
5.Peking Univ, Peoples Hosp, Dept Anesthesiol, Beijing 100044, Peoples R China
6.Peking Univ, Hosp 3, Dept Anesthesiol, Beijing 100191, Peoples R China

Recommended Citation:
Li, Ya-Wei,Li, Hui-Juan,Li, Huai-Jin,et al. Effects of two different anesthesia-analgesia methods on incidence of postoperative delirium in elderly patients undergoing major thoracic and abdominal surgery: study rationale and protocol for a multicenter randomized controlled trial[J]. BMC ANESTHESIOLOGY,2015,15.
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