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头颈部肿瘤修复术后谵妄的危险因素：一项回顾性临床试验
Authors Li L , Zhang L, Wu X, Zeng Z
Received 28 May 2024
Accepted for publication 14 January 2025
Published 24 January 2025 Volume 2025:21 Pages 81—91
DOI https://doi.org/10.2147/TCRM.S480272
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Garry Walsh
Lulan Li,1,* Liupan Zhang,1,2,* Xixuan Wu,1 Zhenhua Zeng1
1Department of Critical Care Medicine, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China; 2Department of Internal Medicine, Zhongshan Shenwan Hospital, Zhongshan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhenhua Zeng, Department of Critical Care Medicine, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Baiyun District, Guangzhou, 510515, People’s Republic of China, Tel/Fax +86 20 61641884, Email zhenhuazeng.2008@163.com
Background: Patients after head and neck tumor reconstruction surgery frequently require deep sedation and analgesia in the ICU. However, the risk factors for delirium associated with propofol-based sedation remain unclear.
Objective: The study aimed to explore the risk factors of delirium of propofol singled or combined sedation.
Methods: This retrospective study analyzed ICU patients who underwent head and neck tumor reconstruction surgery. The patients were divided into three groups: propofol (P), propofol + midazolam (PM), and propofol + dexmedetomidine (PD) groups. We utilized univariate and multivariate logistic regression to identify risk factors of delirium.
Results: Delirium occurred in 4 (7.02%), 11 (28.21%), and 5 (20.83%) patients in the P, PM and PD groups, respectively. Elevated mean arterial pressure (MAP), increased aspartate aminotransferase (AST) levels, and the combined use of midazolam were determined to be significant risk factors for delirium in this patient cohort. The combined use of midazolam is the strongest predictor of delirium, which can increase the risk of delirium by 3.218 times (95% CI = 1.041– 9.950, p = 0.042).
Conclusion: Propofol combined with midazolam for sedation in patients after head and neck tumor reconstruction surgery may increase the risk of delirium.
Keywords: head and neck tumor reconstruction, delirium, propofol, midazolam, sedation, ICU