Uticaj anestezije na razvoj postoperativnog delirijuma
Sažetak
Uvod: Postoperativni delirijum se definiše kao akutno stanje konfuzije koje se razvija u roku od nekoliko sati ili dana nakon hirurške intervencije. Sa globalnim starenjem svetske populacije, broj gerijatrijskih pacijenata koji će se podvrgnuti hirurgiji je u stalnom porastu, čime se povećava mogućnost postoperativnog delirijuma.
Cilj: Primarni cilj ovog istraživanja bio je da se utvrdi efekat godina, tipa hirurške procedure, kao i tipa anestezije na postoperativni delirijum.
Metode: Istraživanje je izvedeno u formi prospektivne studije. Uključeni su pacijenti koji su bili podvrgnuti opštoj i regionalnoj anesteziji. Za premedikaciju su korišćeni benzodiazepini i atropin; od intravenskih anestetika korišćen je propofol za hipnozu, a od inhalacionih sevofluran; za analgeziju su korišćeni opioidi. Bupivakain je korišćen za sprovođenje regionalne anestezije. Nivo kognitivne funkcionalnosti testiran je korišćenjem dva testa: Mini mental test u preoperativnom periodu i CAM-ICU u postoperativnom periodu.
Rezultati: Korišćenjem t-testa za nezavisne uzorke, utvrđeno je da postoji statistički značajna razlika između dve starosne grupe pacijenata. Takođe je utvrđeno da ne postoji statistički značajna razlika u pogledu kognitivnog funkcionisanja između pacijenata koji su primili opštu anesteziju i onih koji su primili regionalnu anesteziju. Rezultati analize su pokazali da ne postoji statistički značajna razlika između grupa koje su bile podvrgnute različitim tipovima hirurških zahvata.
Zaključak: Praktična vrednost ovog istraživanja je da priprema pacijenata za ove vrste abdominalnih intervencija može da prati opšta uputstva.
Reference
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