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已发表论文
比较的影响的格隆溴铵和阿托品对术后谵妄在老年患者接受腹腔镜结直肠手术：一项随机对照试验
Authors Wu J, Liu J, Wang C, Wu J, Lin Y, Wang G, Zhang S, Ding M, Liang C
Received 9 November 2025
Accepted for publication 23 January 2026
Published 5 February 2026 Volume 2026:20 580157
DOI https://doi.org/10.2147/DDDT.S580157
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Solomon Tadesse Zeleke
Junmei Wu,1,* Juanlan Liu,1,* Chengyu Wang,2,* Jingyi Wu,1 Yimei Lin,1 Guoli Wang,1 Suqin Zhang,1 Ming Ding,1,2 Chao Liang1,2
1Department of Anesthesiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, People’s Republic of China; 2Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chao Liang, Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, Tel/Fax +86-021-64041990, Email superwm226@126.com Ming Ding, Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, Tel/Fax +86-021-64041990, Email drdingming@126.com
Background: Postoperative delirium (POD) is a common complication that hinders recovery in older patients. This study aimed to compare the effects of glycopyrrolate and atropine, used to counteract the peripheral effects of neostigmine, on POD incidence in older patients undergoing laparoscopic colorectal surgery.
Methods: This single-centre, double-blind, randomized controlled trial recruited patients (aged 65– 80 years) undergoing laparoscopic colorectal surgery. Patients were randomized to receive either glycopyrrolate (0.04 mg kg− 1 neostigmine and 0.008 mg kg− 1glycopyrrolate) or atropine (0.04 mg kg− 1 neostigmine and 0.016 mg kg− 1 atropine) during emergence from anaesthesia. The primary outcome was the incidence of POD within the first 3 postoperative days, assessed using the 3-minute Diagnostic Interview for Confusion Assessment Method. Secondary outcomes included comparing the hemodynamic effects of glycopyrrolate and atropine and examining POD biomarkers.
Results: Among 121 patients, the glycopyrrolate group had a significantly lower incidence of POD compared with the atropine group (11.7% vs 27.9%; relative risk, 0.42; 95% confidence interval, 0.19– 0.94; p = 0.045). Glycopyrrolate better maintained baseline heart rate and mean arterial pressure. No significant differences were observed in plasma levels of neurofilament light chain, neuron-specific enolase, and Tau protein between groups at different time points.
Conclusion: The combination of glycopyrrolate and neostigmine was associated with a lower incidence of POD than atropine in older adults undergoing laparoscopic colorectal surgery.
Registration: Chinese Clinical Trial Registry, ChiCTR2300072798.
Keywords: postoperative delirium, glycopyrrolate, atropine, older adult patients, colorectal surgery
1Department of Anesthesiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, People’s Republic of China; 2Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chao Liang, Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, Tel/Fax +86-021-64041990, Email superwm226@126.com Ming Ding, Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, Tel/Fax +86-021-64041990, Email drdingming@126.com
Background: Postoperative delirium (POD) is a common complication that hinders recovery in older patients. This study aimed to compare the effects of glycopyrrolate and atropine, used to counteract the peripheral effects of neostigmine, on POD incidence in older patients undergoing laparoscopic colorectal surgery.
Methods: This single-centre, double-blind, randomized controlled trial recruited patients (aged 65– 80 years) undergoing laparoscopic colorectal surgery. Patients were randomized to receive either glycopyrrolate (0.04 mg kg− 1 neostigmine and 0.008 mg kg− 1glycopyrrolate) or atropine (0.04 mg kg− 1 neostigmine and 0.016 mg kg− 1 atropine) during emergence from anaesthesia. The primary outcome was the incidence of POD within the first 3 postoperative days, assessed using the 3-minute Diagnostic Interview for Confusion Assessment Method. Secondary outcomes included comparing the hemodynamic effects of glycopyrrolate and atropine and examining POD biomarkers.
Results: Among 121 patients, the glycopyrrolate group had a significantly lower incidence of POD compared with the atropine group (11.7% vs 27.9%; relative risk, 0.42; 95% confidence interval, 0.19– 0.94; p = 0.045). Glycopyrrolate better maintained baseline heart rate and mean arterial pressure. No significant differences were observed in plasma levels of neurofilament light chain, neuron-specific enolase, and Tau protein between groups at different time points.
Conclusion: The combination of glycopyrrolate and neostigmine was associated with a lower incidence of POD than atropine in older adults undergoing laparoscopic colorectal surgery.
Registration: Chinese Clinical Trial Registry, ChiCTR2300072798.
Keywords: postoperative delirium, glycopyrrolate, atropine, older adult patients, colorectal surgery