TPVB和全身麻醉会影响老年患者的术后功能恢复,这些老年患者经过基于ERAS途径的胸腔镜肺切除
Na An1, Wenzhe Dong1, Guangdong Pang1
1Department of Anesthesia 1, Inner Mongolia People's Hospital, Hohhot 010020, Inner Mongolia, China.
Translational neuroscience
|September 18, 2023
概括
胸部副脊椎阻塞与全身麻醉相结合,改善了接受手术的老年肺癌患者的康复. 这种方法可以减少疼痛,加快恢复速度,并降低手术后增强恢复途径中的并发症率.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 老年医学 老年医学
背景情况:
- 接受胸部手术的老年患者由于生理衰退而面临更高的术后并发症风险.
- 手术后的认知功能障碍是胸部手术后这个人口群体经常关注的问题.
- 手术后增强恢复 (ERAS) 途径旨在优化术后护理并改善结果.
研究的目的:
- 评价胸部副脊椎阻塞 (TPVB) 与全身麻醉对老年患者术后功能恢复的影响.
- 在ERAS框架内评估这种综合方法的疗效,用于胸腔镜肺癌切除.
- 为了比较TPVB加全身麻醉和单独全身麻醉之间的康复指标和并发症率.
主要方法:
- 104名接受胸腔镜肺癌切除术的老年患者 (≥60岁) 被随机分为两组:单独全身麻醉 (对照) 或TPVB与全身麻醉 (组合) 结合.
- 这两组都遵循了ERAS协议.
- 测量的主要结果包括血液动力学稳定性,疼痛评分,止痛要求,炎症和压力标志物,瘤标志物,肺功能,6分钟的步行距离和临床康复指标.
主要成果:
- 组合组在麻醉后和手术期间表现出明显较低的心率和平均动脉压.
- 接受TPVB治疗的患者减少了手术内麻醉的需求,降低了术后疼痛得分,并减少了止痛药的使用.
- TPVB组表现出加速恢复,包括更短的住院时间,更早的动员,更快的胸管切除,更快的恢复食,以及改善胃肠功能恢复,并减少并发症和增强肺功能.
结论:
- 在ERAS途径中,胸部副脊椎阻塞与全身麻醉相结合,可增强接受胸腔镜肺癌手术的老年患者的术后恢复.
- 这种联合麻醉技术有效地减轻了血液动力学不稳定性,缓解了手术后的疼痛,并减少了并发症的发生率.
- 这些发现支持将TPVB整合到ERAS协议中,以改善这一脆弱人群的功能恢复和患者结果.
相关概念视频
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
15
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
15
01:23Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
01:24General Anesthesia: Overview
240
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
240
01:26Endoscopic Studies II: Thoracocentesis
323
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
323