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| Effect of optimized sedation and analgesia management on postoperative delirium in neurosurgical patients |
| YANG Xi-mei DENG Xin-zheng WANG Jin-hua CHEN Nuo |
| Intensive Care Unit,Dongguan Chang′an Hospital,Guangdong Province,Dongguan 523843,China |
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Abstract Objective To explore the application effect of optimized sedation and analgesia management in postoperative delirium(POD)of neurosurgical patients.Methods A total of 82 patients who underwent neurosurgery in Dongguan Chang′an Hospital from October 2017 to December 2019 were selected as the research subjects.According to the random number table method,they were divided into optimization group(41 cases)and routine group(41 cases).The optimization group was given optimized sedation and analgesia management,while the routine group was given routine operation anesthesia and pain management.Duration of delirium,incidence of inadequate sedation,unplanned extubation,effectiveness of sedation(Ramsay sedation scale)analgesia(pain observation instrument [CPOT]scale for the intensive care unit [ICU]),incidence of POD,quality of care and satisfaction were compared between the two groups.Results The duration of delirivon,the incidence of improper sedation and unplanned extubation in the optimization group were lower than those in the routine group,and the differences were statistically significant(P＜0.05).Ramsay and CPOT scores in the optimization group at 10 and 30 min before operation were lower than those in the routine group,and the differences were statistically significant(P＜0.05).The incidence of POD in the optimization group was lower than that in the routine group,and the difference was statistically significant(P＜0.05).The score of nursing activity assessment scale(NAS)and the excellent and good rate of satisfaction in the optimization group were higher than those in the routine group,and the differences were statistically significant(P ＜0.05).Conclusion Optimization of sedation and analgesia management can effectively reduce the adverse events of sedation and analgesia in neurosurgery patients during perioperative period,improve the quality of nursing,reduce the incidence of POD,and have high safety.
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