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相关概念视频

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...

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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

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治疗下大脑关节出血的区域化:成本效益分析

Naomi S Bardach1, Scott J Olson, Jacob S Elkins

  • 1School of Medicine, University of California, San Francisco, CA 94143-01, USA.

Circulation
|May 1, 2004
PubMed
概括

通过将患者从低流量医院转移到高流量医院来区域化治疗下关节出血 (SAH) 是具有成本效益的. 这种方法改善了健康结果,并证明了对SAH患者的集中护理的合理性.

科学领域:

  • 卫生经济学 卫生经济学
  • 神经外科 神经外科
  • 公共卫生政策 公共卫生政策

背景情况:

  • 高体积的医院可以改善脑下关节下出血 (SAH) 患者的治疗结果,但成本更高.
  • 区域化SAH护理的成本效益仍然没有确定.

研究的目的:

  • 为了评估加利福尼亚州亚脑下出血 (SAH) 患者的区域化护理的成本效益.
  • 将当前的护理模式与将SAH患者转移到大量中心的拟议模型进行比较.

主要方法:

  • 使用马尔科夫模型进行了成本效益分析.
  • 在两个情景中,健康结果 (QALYs) 和每QALY的成本进行了比较:现行做法与区域化护理.
  • 模型输入来自文学和加利福尼亚队列研究.

主要成果:

  • 将SAH患者从低体积 (<20年入院) 转移到高体积 (>=20年入院) 的医院,获得了1.60个QALY的收益,每QALY10.548美元.
  • 边界成本效益 (5万美元/QALY) 需要死亡率差异明显较小或转移死亡率风险高于估计.

结论:

  • 通过将患者转移到大量医院来区域化下关节出血 (SAH) 护理是一种具有成本效益的策略.

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Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
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Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model

Published on: June 18, 2021

  • 集中SAH护理可能是合理的,但需要进一步的队列研究来证实体积与结果的关系.