翻译：何幼芹 编辑：冯玉蓉 审校：曹莹
方法：将行全髋/膝关节置换术的老年患者随机分为丙泊酚麻醉组(N = 106)和七氟烷麻醉组(N = 103)。由对麻醉方案不知情的调查人员使用意识模糊评估法评估术后第1、2、3天术后谵妄的发生率和持续时间(每人术后谵妄天数)。
结果：共209例老年患者(年龄71.2±6.7岁，男性29.2%)进入最终数据分析。丙泊酚麻醉组和七氟烷麻醉组术后谵妄的发生率分别为33.0%和23.3%(P = 0.119，卡方检验)，我们估计每组需要316名受试者才能检测到潜在的统计学差异。丙泊酚麻醉组术后谵妄天数(0.5 ± 0.8)明显长于七氟烷麻醉组(0.3±0.5，P = 0.049，t检验)。
原始文献来源：Mei X, Zheng HL, Li C, et al. The Effects of Propofol and Sevoflurane on Postoperative Delirium in Older Patients: A Randomized Clinical Trial Study[J] .J.Alzheimers Dis., 2020, 76: 1627-1636.
The Effects of Propofol and Sevoflurane on Postoperative Delirium in Older Patients: A Randomized Clinical Trial Study
Background: Postoperative delirium is associated with adverse postoperative outcomes. However, whether intravenous and inhalation anesthetics are associated with different risks of postoperative delirium remains unknown.
Objective: We set up to determine the incidence and duration of postoperative delirium in older patients who had surgery under the intravenous anesthetic propofol or the inhalational anesthetic sevoflurane.
Methods: Participants were patients who had total hip/knee replacements and were randomized to propofol (N = 106) or sevoflurane (N = 103) anesthesia group. The Confusion Assessment Method was employed by investigators who were blinded to the anesthesia regimen to assess the incidence and duration (days of postoperative delirium per person) of postoperative delirium on postoperative days 1, 2, and 3.
Results: A total of 209 participants (71.2 ± 6.7 years old, 29.2% male) were included in the final data analysis. The incidence of postoperative delirium was 33.0% with propofol anesthesia and 23.3% with sevoflurane anesthesia (p = 0.119, Chi-square test), and we estimated that we would need 316 participants in each arm to detect a potential statistically significant difference. Days of postoperative delirium per person were higher in the propofol (0.5 ± 0.8) anesthesia group compared to the sevoflurane anesthesia group (0.3 ± 0.5, p = 0.049, Student’s t-test).
Conclusion: This pilot study established a system to compare effects of different anesthetics and generated a hypothesis that propofol trended to have a higher incidence and had longer duration of postoperative delirium than sevoflurane. Additional studies with a larger sample size are needed to test this hypothesis.