脊柱与全身麻醉:比较小儿科患者进行泌尿外科手术的结果
Nicole Ambrose1, Kesavan Sadacharam2, Brian Burke3
1Department of Urology, Main Line Health. Bryn Mawr, PA 19010, USA.
Journal of pediatric urology
|July 24, 2023
概括
脊柱麻醉 (SA) 是儿童泌尿外科手术中全身麻醉 (GA) 的安全有效替代品,可减少阿片类药物使用和并发症. 进一步的研究可能会强调SA作为特定患者群体的更安全,更具成本效益的选择.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 泌尿外科手术 泌尿外科手术
- 区域麻醉技术 区域麻醉技术
背景情况:
- 在儿童患者中,将脊柱麻醉 (SA) 与全身麻醉 (GA) 进行比较的文献表明了降低成本和并发症等好处.
- 专门比较SA和GA用于儿科泌尿外科手术的数据有限.
研究的目的:
- 研究SA与GA相比,SA在儿科泌尿外科手术中的有效性和安全性.
- 为了解决这个特定的外科患者群体中关于SA的文学缺乏.
主要方法:
- 一项回顾性研究比较了在SA和GA下接受泌尿外科手术的儿科患者 (<18个月) 与GA.
- 统计分析包括两个样本的t测试,独立性的奇平方测试和费舍尔的精确测试.
主要成果:
- 脊髓麻醉 (SA) 患者需要在手术前和手术后显著减少阿片类药物的使用 (分别为0%,26.1%和0%,18.2%).
- SA与需要PICU入院或取消手术的并发症较少相关 (0%对6.8%,p=0.03).
- 在SA患者中,全麻醉和出现时间显著缩短 (p<0.001).
结论:
- 脊椎麻醉 (SA) 是儿童泌尿外科手术中全身麻醉 (GA) 的有效和适当替代品.
- SA提供了潜在的好处,包括减少阿片类药物需求,减少并发症和缩短麻醉时间.
- 进一步调查SA作为风险儿童患者接受泌尿外科手术的更安全,更具成本效益的选择是有必要的.
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