脊椎与部骨折手术全身麻醉的长期结果:随机试验
Emily A Vail1, Rui Feng2, Frederick Sieber3
1Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania.
Anesthesiology
|October 13, 2023
概括
脊髓麻醉和全身麻醉在关节骨折患者中显示出类似的长期存活率和功能恢复. 这项随机试验发现这两种麻醉类型之间的结果没有显著差异.
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:
- 脊柱与全身麻醉的长期结果尚未得到充分证实.
- 骨折修复是老年患者常见的手术.
研究的目的:
- 为了测试脊髓麻醉导致较好长期生存和功能恢复的假设,与全身麻醉相比.
- 评估麻醉类型对部骨折手术后死亡率和出行率的影响.
主要方法:
- 一项随机优势试验将脊柱麻醉与50岁及以上的患者的关节骨折修复全身麻醉进行了比较.
- 该研究分析了长期结果,包括365天的生存,行走的恢复和复合终点.
- 在46家医院招募了1600名患者,结果由蒙面调查人员评估.
主要成果:
- 在脊椎 (98例死亡) 和全身麻醉 (92例死亡) 组之间,365天的存活率没有显著差异 (HR,1.08;P = 0.59).
- 在365天的幸存者中,行走的恢复在两个麻醉组之间也是相似的 (aOR,0.87;P = 0.31).
- 在死亡的复合终点或新的无法行走或搬到养老院的综合终点中没有观察到任何显著差异.
结论:
- 长期的结果,包括生存和功能恢复,在接受关节骨折修复的患者中与脊柱和全身麻醉相似.
- 在脊椎和全身麻醉之间进行骨折修复的选择可能不会显著影响患者的长期结果.
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