对于严重的全身性疾病的老年关节骨折进行全静脉麻醉
Yu-Yi Huang1,2, Chung-Kun Hui3, Ngi-Chiong Lau1,2
1Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, No. 222, Maijin Rd., Anle Dist., Keelung City, 204, Taiwan.
在老年部外科手术患者的Fascia iliaca compartment block加全静脉麻醉 (FICB + TIVA) 减少了ICU停留时间和阿片类药物的使用,相比于全身麻醉. 这种新的技术推用于高风险的老年患者.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 整形外科手术 整形外科手术
背景情况:
- 接受部手术的严重全身疾病 (ASA IV) 的老年患者面临重大风险.
- 优化麻醉技术对于改善这一弱势群体的临床结果至关重要.
研究的目的:
- 为了评估 Fascia iliaca compartment block 加上基于 propofol 的全静脉麻醉 (FICB + TIVA) 与全静脉麻醉 (GA) 对严重全身疾病的老年部手术患者临床结果的影响.
主要方法:
- 对接受关节骨折手术的老年患者 (65岁以上,ASA IV) 的回顾性研究.
- 两个麻醉组之间的比较:FICB + TIVA和GA.
- 主要结局:30天和1年死亡率. 二次结局:住院和ICU,术后发病率,疼痛评分和止痛药消耗.
主要成果:
- 在FICB+TIVA和GA组之间,30天或1年死亡率没有显著差异.
- 在FICB+TIVA组中,ICU需求显著降低,ICU和住院时间缩短.
- 接受FICB + TIVA治疗的患者需要较少的术后阿片类止痛药.
结论:
- FICB + TIVA与ICU入院减少,住院和ICU停留时间缩短以及严重全身疾病的老年部手术患者的术后阿片类药物消耗减少有关.
- 该研究建议FICB + TIVA用于接受关节骨折手术的高风险老年患者.
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