翻译：吴学艳 编辑：冯玉蓉 审校：曹莹
结果：本综述评估了一系列干预方法，比较了麻醉剂和镇静剂、药物特异性干预和多学科护理模式。结果发现与药物干预相比，多学科干预的结果更加一致。在汇总分析中，氟哌啶醇(OR 0.74；95%CI 0.44，1.26)与安慰剂相比，在降低POD发病率方面没有统计学意义。
原始文献来源: Igwe EO, Nealon J, Mohammed M, et al. Multi-disciplinary and pharmacological interventions to reduce post-operative delirium in elderly patients: A systematic review and meta-analysis.[J].J Clin Anesth 2020 Aug 05;67DOI：10.1016/j.jclinane.2020.110004.
Multi-disciplinary and pharmacological interventions to reduce post-operative delirium in elderly patients: A systematic review and meta-analysis
Study objective: An estimated 80% of older people undergoing surgery develop postoperative delirium (POD) making them a high-risk group. Research in this area is growing fast but there is no established consensus on strategies for POD prevention or management. A systematic review and meta-analysis were conducted to synthesise data on clinical interventions used to reduce POD among older people undergoing elective and emergency surgery.
Methods: A range of database searches generated 336 papers. A total of 25 studies met the inclusion criteria and were assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The studies were undertaken across the world.
Results: This review identifified a range of intervention approaches: comparisons between anaesthetic and sedatives agents, medication-specifific interventions and multidisciplinary models of care. Results found more consistencies across multidisciplinary interventions than the pharmacological interventions. In pooled analyses, haloperidol (OR 0.74; 95% CI (confifidence interval) 0.44, 1.26) was not statistically signifificantly associated with reduced POD incidence any more than a placebo.
Conclusion: There is a need to implement multidisciplinary interventions, as well as collaboration between clinicians on pre- and postoperative care practices regarding pharmacological interventions to more effffectively reduce and manage POD in older people.