在接受关节骨折手术的患者中,比较区域麻醉和全身麻醉之间的术后结果:系统性审查和元分析
Song Liu1, Jianan Chen1, Huihong Shi1
1Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|February 28, 2024
概括
与全身麻醉 (GA) 相比,区域麻醉 (RA) 并没有降低关节骨折手术的30天死亡率. 然而,RA与手术内低血压较少相关,其他并发症没有显著差异.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 老年医学 老年医学
背景情况:
- 关节骨折手术很常见,麻醉的选择会影响患者的治疗结果.
- 关节骨折修复的最佳麻醉技术仍然是争论的主题.
研究的目的:
- 进行更新的系统审查和元分析,比较部骨折手术中全身麻醉 (GA) 与区域麻醉 (RA) 的临床结果.
主要方法:
- 搜索了MEDLINE,Embase,科学网络和可克兰图书馆的RCT和观察研究 (2000年-5月2023年).
- 分析结果包括死亡率 (30天,90天,住院),外科手术后并发症和住院时间.
- 使用随机效应模型进行元分析,通过研究设计进行子组分析.
主要成果:
- 包括12个随机对照试验;RA和GA之间30天死亡率没有显著差异.
- 与全身麻醉相比,区域麻醉与手术内低血压的发生率较低有关.
- 在90天死亡率,住院死亡率或其他主要并发症 (如狂妄症,肺炎或VTE) 中没有发现显著差异.
结论:
- 与全身麻醉相比,区域麻醉在关节骨折手术中没有降低30天的死亡率.
- 区域麻醉与减少手术内低血压有关.
- 目前的证据表明,除了低血压之外,关节骨折手术中RA和GA之间主要并发症没有显著差异.
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