术后谵妄是一种常见的术后并发症，主要表现为急性起病，注意力不集中，意识水平改变和思维紊乱，常见于老年患者。关节置换术以老年患者为主，手术创伤大，术后谵妄发生率高。目前针对术后谵妄的防治药物主要有右美托咪定、帕瑞昔布钠、抗精神病药物和激素类。对老年患者关节置换术后谵妄的防治药物进行综述，为临床麻醉提供参考。

Postoperative delirium is a common postoperative complication with the main manifestations of acute onset, inattention, altered level of consciousness, and disordered thinking, and it is commonly seen in elderly patients. Joint replacement is mainly for elderly patients, but the surgery is traumatic, and postoperative delirium has a high incidence. At present, the main prevention and treatment drugs for postoperative delirium are dexmedetomidine, parecoxib sodium, antipsychotic drugs, and hormones. Drugs in prevention and treatment of postoperative delirium after joint replacement in the elderly patients are reviewed in this paper, to provide reference for clinical anesthesia.

R971

卫生部国家临床重点专科建设项目[财社（2011）170号]；重庆市医学重点学科项目[渝卫科教（2007）2]