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在门诊手术中使用麻醉的定量分析

Lucas P Bowen¹, Dean W Smith¹, Jacob Siahaan¹

¹Department of Orthopaedic Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.

The Iowa orthopaedic journal

|January 12, 2024

概括

当地麻醉 (LA) 在手术中最常见,但其使用略有减少. 区域麻醉 (RA) 和全身麻醉 (GA) 的使用也出现了轻微的变化,十年来没有显著的个体增长.

科学领域:

整形外科手术整形外科手术
麻醉学麻醉学
医疗服务研究医疗服务研究

背景情况:

尽管有越来越多的证据表明局部麻醉有好处,但对于外科手术的最佳麻醉方式缺乏共识.
一般和区域麻醉仍然是特定患者和程序因素的首选选择,包括焦虑,复杂性和疼痛耐受性.

研究的目的:

分析2010年至2019年间常见的门诊手术中麻醉剂使用趋势.
为了调查这一假设,局部麻醉剂 (包括无围的广觉局部麻醉 - WALANT) 的使用在此期间增加,而一般和区域麻醉剂的使用在此期间减少.

主要方法:

2010-2019年德克萨斯州医疗保健信息收集门诊数据库的横截面分析.
包括门诊手术,如手掌道释放,触发指释放和手体切除.
麻醉选择分类为区域麻醉 (RA),局部或WALANT麻醉 (LA) 和全身麻醉 (GA).

主要成果:

在分析的340,117项手术中,98.14%使用局部麻醉 (LA).
在研究期间,没有观察到LA (-0.12%),RA (0.09%) 或GA (0.03%) 的显着个体增长.
在比较所有模式 (p<0.001) 时,观察到麻醉剂使用的比例有显著的转变,商业/私人保险是最常见的支付者.

结论:

局部麻醉 (LA) 仍然是门诊手术中的主要麻醉方式.
尽管LA的患病率很高,但随着时间的推移,地区麻醉 (RA) 和全身麻醉 (GA) 的使用增加,出现了显著的转变.
医疗补助不成比例地覆盖了在GA下执行的程序,RA的使用在中型人口中心更高.

关键词:

这是一种门诊外科手术.麻醉是一种麻醉.手术手术手术手术手术手术手术手术手术整形外科手术整形外科手术

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