沟修复中的局部,区域或全身麻醉:多中心随机试验
Pär Nordin1, Henrik Zetterström, Ulf Gunnarsson
1Department of Surgery, Ostersund Hospital, Ostersund, Sweden. par.nordin@jll.se
Lancet (London, England)
|September 19, 2003
概括
局部麻醉在沟的手术中具有显著的好处,包括更少的并发症和更短的住院时间. 这些优势是普通外科医生在日常实践中可以重现的,挑战了对区域性或全身麻醉的偏好.
科学领域:
- 手术麻醉学手术麻醉学
- Hernia 修复技术 的修复技术
- 临床试验方法论 临床试验方法论
背景情况:
- 地方麻醉是沟手术专业中心的标准,与常规实践中的区域/全身麻醉形成鲜明对比.
- 进行了一项多中心随机试验,以比较沟修复的局部,区域和全身麻醉.
- 这项研究旨在评估局部麻醉结果的可重现性,以评估外科医生在专业环境之外的局部麻醉结果.
研究的目的:
- 为了比较本地,区域和全身麻醉在沟瘤手术中的疗效和安全性.
- 评估一般外科医生在日常实践中复制局部麻醉的成功的可行性.
- 为了确定沟修复的最佳麻醉方法,关于患者的结果和资源利用.
主要方法:
- 一个三臂,多中心随机试验,涉及1999年至2001年期间的616名患者.
- 患者被分配接受局部,区域或全身麻醉.
- 主要终点包括早期和晚期的术后并发症;次要终点包括手术持续时间,住院时间和恢复正常活动. 进行了治疗意向分析.
主要成果:
- 局部麻醉在早期术后结果中表现出高的术内耐受性和优越性.
- 在麻醉组的8天和30天随访期间,没有观察到并发症的显著差异.
- 虽然手术持续时间较长,但局部麻醉的总麻醉时间与区域或全身麻醉相比明显较短.
结论:
- 局部麻醉提供了显著的优势,包括减少住院,减少术后疼痛和减少排尿问题.
- 专业中心局部麻醉的积极结果在很大程度上可以被一般外科医生在标准实践中重现.
- 局部麻醉是一种有利且有效的麻醉选择,用于在各种手术环境中修复沟.
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