在接受手术的患者中,脊髓麻醉失败的发生率和相关因素:一项多中心前性观察性研究
Atalay Eshetie Demilie1, Zewditu Abdissa Denu2, Yosef Belay Bizuneh2
1Department of Anaesthesia, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
BMC anesthesiology
|April 5, 2024
概括
在埃塞俄比亚的阿姆哈拉,在22.4%的手术中,脊椎麻醉失败. 紧急手术和经验较少的麻醉师等因素增加了这种风险,突出了改善技术和培训的必要性.
科学领域:
- 麻醉学 麻醉学
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 脊柱麻醉失败会延长手术,需要重复手术,并可能导致严重的并发症,如局部麻醉毒性或转换为全身麻醉.
- 在埃塞俄比亚阿姆哈拉地区的综合专科医院中,脊柱麻醉失败的发生率和促成因素仍未得到充分探索.
研究的目的:
- 为了确定脊柱麻醉失败的发生率.
- 确定与阿姆哈拉国家区域国家综合专科医院 (西北埃塞俄比亚) 接受手术的患者脊髓麻醉失败相关的因素.
主要方法:
- 一项多中心前性观察性研究,涉及532名接受预定紧急和选择性手术的患者.
- 通过问卷和检查清单收集的数据,在SPSS.中使用后勤回归进行分析.
- 统计学意义以p值<0.05来确定,并计算原始和调整的赔率比率.
主要成果:
- 脊髓麻醉失败的发生率为22.4% (95% CI: 19-25.9).
- 重要相关因素包括紧急手术 (AOR=7.01),布皮瓦卡因剂量≤10毫克 (AOR=3.02),麻醉师经验<2年 (AOR=3.1),血脑脊液 (CSF) (AOR=8.5),高压局部麻醉 (AOR=3.3) 和缺乏辅助剂 (AOR=5.25).
结论:
- 在阿姆哈拉地区观察到,脊髓麻醉失败的高发病率.
- 建议包括通过适当的局部麻醉剂剂量和辅助剂的使用来最大限度地减少失败.
- 麻醉提供者加强培训,包括模拟,对于提高技能和患者结果至关重要.
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