Effects of oral premedication on cognitive status of elderly patients undergoing cardiac catheterization  

作　　者：Javed M Ashraf Marc Schweigel Neelima Vallurupalli Sandra Bellantonio James R Cook 

机构地区：[1]Department of Cardiology, Truman Medical Center, UMKC School of Medicine, Kansas City, MO, USA [2]Departments of Cardiology, Baystate Medical Center, Tufts University School of Medicine, MA, USA [3]Department of Internal Medicine and Geriatrics, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA

出　　处：《Journal of Geriatric Cardiology》2015年第3期257-262,共6页老年心脏病学杂志（英文版）

摘　　要：Background Sedatives and analgesics are often administered to achieve conscious sedation for diagnostic and therapeutic procedures. Appropriate concerns have been raised regarding post procedure delirium related to peri-procedural medication in the elderly. The objective of this study was to investigate the effect of premedication on new onset delirium and procedural care in elderly patients. Methods Patients 〉 70 years old and scheduled for elective cardiac catheterization were randomly assigned to receive either oral diphenhydramine and diaze- pam （25 rag/5 mg） or no premedication. All patients underwent a mini mental state exam and delirium assessment using confusion assess- ment method prior to the procedure and repeated at 4 h after the procedure and prior to discharge. Patients＇ cooperation during the procedure and ease of post-procedure were measured using Visual Analog Scale （VAS）. The degree of alertness was assessed immediately on arrival to the floor, and twice hourly afterwards using Observer＇s Assessment of Alermess/Sedation Scale （OAA/S）. Results A total of 93 patients were enrolled. The mean age was 77 years, and 47 patients received premedication prior to the procedure. None of the patients in either group developed delirium. Patients＇ cooperation and the ease of procedure was greater and pain medication requirement less both during and after the procedure in the pre-medicated group （P 〈 0.05 for both）. Nurses reported an improvement with patient management in the pre-medicated group （P = 0.08）. Conclusions In conclusion, prcmedication did not cause delirium in elderly patients undergoing cardiac catheterization. The reduced pain medication requirement, perceived procedural ease and post procedure management favors premedication in elderly patients undergoing cardiac catheterization.

关 键 词：Cardiac catheterization DIPHENHYDRAMINE DIAZEPAM DELIRIUM The elderly 

分 类 号：S858.28[农业科学—临床兽医学] TP393.08[农业科学—兽医学]