在局部麻醉下,八胞胎患者的情况更好,用于选择性内血管大动脉动脉瘤修复
Christopher DeHaven1, Ahsan Zil-E-Ali2, Elizabeth Lavanga1
1Department of Medical Education, Penn State University, College of Medicine, Hershey, PA.
Journal of vascular surgery
|December 23, 2023
概括
与全身麻醉 (GA) 相比,局部麻醉 (LA) 用于八岁以上人体内血管内腹腔大动脉动脉瘤修复 (EVAR) 显著减少住院和呼吸道并发症. 这种方法也导致了更短的手术时间和更少的血液损失,而死亡率没有增加.
科学领域:
- 血管外科 血管外科
- 麻醉学 麻醉学
- 老年医学 老年医学
背景情况:
- 八代人代表着越来越多的人群接受选择性内血管腹腔大动脉瘤修复 (EVAR).
- 以前的研究表明,局部麻醉 (LA) 在一般人群中为EVAR提供了比一般麻醉 (GA) 更好的结果.
研究的目的:
- 调查LA和选择性EVAR的术后结果之间的关联,特别是在八十多岁的患者中.
- 为了比较经过EVAR的八十岁人群中LA与GA的结果.
主要方法:
- 使用了血管质量倡议数据库 (2003-2021年).
- 选择了八十岁以上的年轻人 (≥80岁),并将他们分为LA (I组) 和GA (II组) 组.
- 主要结局:住院时间和死亡率. 二次结局:手术时间,血液损失,返回手术室,心肺复发症,放电位置.
主要成果:
- 与GA相比,LA组的手术时间较短 (114.6分 vs 134.6分) 并且流血量较少 (152分 vs 222分).
- 住院时间与住院时间显著缩短 (1.8 vs 2.6 天),住院出院率更高 (88.8% vs 86.9%).
- 在LA组中观察到的肺部并发症 (肺炎,呼吸机支持) 和ICU日数较少. 在30天死亡率或入口部位并发症方面没有显著差异.
结论:
- 八十多岁人群中EVAR的LA与住院时间缩短,呼吸道并发症减少和家庭出院增加有关.
- 此外,LA还可以缩短手术时间,减少血液流失.
- 对于接受EVAR的八十岁老人来说,应该更频繁地考虑LA,以改善结果并减少并发症.
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