褪黑素对神经外科重症监护室住院患者谵妄发生率和住院时间的影响 - 一项前瞻性研究

Anu Hansa, Zulfiqar Ali, Iqra Nazir, Altaf Mir, Zoya Sehar, Mir Mohsin, Shahid Ahmad Mir, I. Naqash
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背景:接受择期手术的患者出现谵妄是一种常见现象。多项研究评估了不同药物在各种择期手术中降低术后谵妄发生率的效果。关于褪黑素对降低神经外科手术患者谵妄发生率和缩短神经外科重症监护室(NSICU)住院时间的效果,此前尚未进行过研究。本研究旨在对这一问题进行评估:评估术前和术后服用褪黑素对在 NSICU 接受择期通气的患者谵妄发生率的影响,并评估术前和术后服用褪黑素对在 NSICU 住院时间的影响:在这项前瞻性观察研究中,共纳入了 60 名接受各种神经外科手术并入住 NSICU 的患者。患者分为两组:一组在术前和术后服用安慰剂(P 组--含阿斯巴甜的无糖片剂),另一组在术前和术后服用 3 毫克褪黑素片剂(M 组)。观察褪黑素对这两组患者谵妄发生率和国家重症监护病房住院时间的影响。结果显示两组(M 组和 P 组)的谵妄率均呈下降趋势,但无统计学意义。与 P 组(43.3%)相比,M 组(33.3%)患者在拔管后 12 小时的谵妄发生率有所下降。M 组和 P 组患者在 NSICU 的平均住院时间分别为 2.7 天和 3.2 天,M 组为 1-14 天,P 组为 1-20 天。结论虽然口服褪黑素的患者谵妄发生率有所下降,重症监护室的平均住院时间也有所缩短,但与对照组相比,这些益处并不具有统计学意义。
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Effects of administration of melatonin on prevalence of delirium and duration of stay in patients admitted to neurosurgical intensive care unit – A prospective study
Background: The occurrence of delirium in patients who undergo elective surgeries is a common occurrence. Multiple studies have assessed the effect of different drugs in various elective procedures to decrease the prevalence of postoperative delirium. The effect of melatonin to decrease the prevalence of delirium and duration of neurosurgical intensive care unit (NSICU) stay in patients undergoing neurosurgery has not been studied previously. The current study aimed to assess the same. Aims and Objectives: To assess the effect of preoperative and postoperative melatonin administration on the prevalence of delirium in patients undergoing elective ventilation in NSICU and to assess the effect of preoperative and postoperative melatonin administration on the duration of stay in NSICU. Methods and Methods: In this prospective observational study, 60 patients undergoing various neurosurgical procedures and admitted to NSICU were included. The patients were divided into two groups: one group received a placebo (Group P- tablet Sugarfree containing Aspartame) and another group received a tablet of melatonin 3 mg (Group M) in the preoperative and postoperative period. The effect of melatonin on the prevalence of delirium and duration of NSICU stay in these two groups was observed. Results: A decreasing trend of delirium was noted in both groups (Group M and Group P) with no statistical significance. A decreased prevalence of delirium was observed in patients of group M (33.3%) at the end of 12 h post-extubation compared to Group P (43.3%). The mean duration of stay for the patients in NSICU in Groups M and P were 2.7 and 3.2 days, with the range (1–14 Days) in Group M and Group P (1–20 days), respectively. Conclusion: Although there was a decreased prevalence of delirium and a decrease in the mean duration of the intensive care unit stay in patients who received oral melatonin, these beneficial effects did not show any statistical significance once compared with the control group.
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