在之前的腰椎脊椎手术的关节关节整形患者中进行麻醉实践
Alex Illescas1, Haoyan Zhong1, Crispiana Cozowicz2
1Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
之前经过腰部融合手术的患者不太可能接受部或膝盖置换的神经轴麻醉. 尽管神经轴技术与更短的住院时间有关,但这突显了需要进一步调查的需要.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 脊柱外科手术 脊柱外科手术
背景情况:
- 神经轴麻醉提供了诸如减少住院时间和骨科手术并发症等好处.
- 之前的腰椎手术可能会影响随后的部或膝盖关节整形术的麻醉选择.
- 之前的腰部融合与减压对神经轴麻醉使用的影响还不清楚.
研究的目的:
- 为了研究神经轴麻醉在接受全关节整形手术 (THA) 或全膝关节整形手术 (TKA) 并且有腰椎手术史的患者中使用的神经轴麻醉.
- 为了比较之前有或没有腰部融合或减压手术的患者之间的神经轴麻醉率.
主要方法:
- 美国国家数据库的回顾性分析.
- 包括接受THA或TKA的患者,通过先前的腰部融合或减压进行分层.
- 使用混合效应回归的神经轴麻醉使用率和并发症率的比较.
主要成果:
- 腰部融合病史与THA (OR:0.74) 和TKA (OR:0.80) 患者的神经轴麻醉使用的几率较低显著相关.
- 在之前的腰部减压手术和神经轴麻醉使用之间没有发现显著的关联.
- 神经轴麻醉的使用始终与不同患者群体停留时间的减少有关.
结论:
- 之前的腰部融合,而不是减压,与THA/TKA患者的神经轴麻醉使用的减少有关.
- 需要进一步的研究,以了解神经轴技术对有脊椎手术史的患者的影响.
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