在COVID-19患者的骨骨折修复后,麻醉技术和死亡之间的关联
Nilufer Nourouzpour1,2, Tim T H Jen2,3, Jonathan Bailey4
1Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|December 21, 2023
概括
麻醉技术对COVID-19的关节骨折患者的30天死亡率没有影响. 这项研究发现,在这个脆弱的患者群体中,一般麻醉和脊髓麻醉之间的生存率没有显著差异.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 整形外科手术 整形外科手术
背景情况:
- 接受关节骨折手术的COVID-19患者面临高死亡风险,在30天内死亡率高达34%.
- 麻醉技术的选择可能会影响这种高风险人群的结果.
研究的目的:
- 为了研究麻醉技术 (一般和脊髓麻醉) 与COVID-19患者的关节骨折手术后30天死亡率之间的关联.
主要方法:
- 从国家外科质量改善计划 (2021) 数据对331名COVID-19患者进行关节骨折手术的回顾性队列分析.
- 患者接受了全身麻醉 (GA) 或脊髓麻醉 (SA).
- 使用多变量逻辑回归分析了麻醉技术与30天全因死亡率之间的关联,并对共变量进行调整.
主要成果:
- 整体30天死亡率为10.0%.
- 脊髓麻醉 (SA) 与全身麻醉 (GA) 相比,与死亡率的降低无关 (调整后的几率比,0.61;95% CI,0.21至1.8).
- 该研究仅限于SA组的小样本大小 (n=59).
结论:
- 麻醉技术 (全身 vs 脊椎) 与接受关节骨折手术的COVID-19患者的30天死亡率没有显著相关.
- 需要进一步研究更大的样本大小来证实这些发现.
- 研究结果表明,目前的麻醉实践可能对这一患者群体充足,但由于研究的局限性,需要谨慎.
相关概念视频
General Anesthesia: Overview
220
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...
220
Stages of General Anesthesia
451
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
451
Local Anesthetics: Clinical Application as Epidural Anesthesia
434
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
434
Local Anesthetics: Clinical Application as Spinal Anesthesia
636
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
636
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
425
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
425


