外围神经阻塞的影响是否因年龄和并发症子组而异? 一项基于全国人口的全国性研究
Haoyan Zhong1, Jashvant Poeran2, Crispiana Cozowicz3
1Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
Regional anesthesia and pain medicine
|July 5, 2023
概括
外周神经阻塞 (PNB) 有利于接受关节整形手术的患者,特别是那些健康问题较少的患者. 在大多数患者群体中,PNB使用与较少的呼吸道并发症和较少的阿片类药物使用有关.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 医疗保健服务研究 医疗服务研究
背景情况:
- 周围神经阻塞 (PNB) 被广泛认为可以改善整个部和膝盖关节整形手术的周围手术结果.
- 通过年龄和健康状况定义的各种患者亚组中PNB的影响仍然不完全理解.
研究的目的:
- 调查PNB使用与全关节形术患者的术后结果之间的关联.
- 分析患者的年龄和健康状况 (并发症) 如何改变PNB对结果的影响.
主要方法:
- 来自Premier Healthcare数据库 (2006-2019) 的关节整形术患者的回顾性分析.
- 混合效应模型被用来评估PNB与呼吸道并发症,功能衰竭,妄,ICU入院,停留时间和阿片类药物消费等结果的关联.
- 根据患者年龄和先前存在的并发症,进行了子组分析.
主要成果:
- 在健康状况良好或不错的成年人和老年人中,PNB使用与呼吸道并发症的可能性降低有关.
- 周围神经阻塞与大多数患者类别中高阿片类药物消费的几率较低相关,不包括健康状况不佳的成年人.
- PNB与结果之间的关联显示出基于患者年龄和健康特征的变化.
结论:
- 周围神经阻塞在全关节关节整形术中提供了显著的周围手术益处.
- 这些好处在伴随性疾病负担较低的患者中更为明显.
- PNB与改善结果之间的关联没有显示出与患者年龄相关的明确模式.
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