在肩部关节镜检查中,用普罗波进行的静脉内全麻醉可缩短排泄时间,与吸入全麻醉相比:一项随机对照试验
Kory J Cablay1, Lucas A Arney1, Nicholas J Peterman2
1Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
The Journal of bone and joint surgery. American volume
|April 10, 2024
概括
与吸入全身麻醉 (IGA) 相比,用普罗波 (TIVA-P) 进行的静脉全身麻醉显著减少了肩膀关节镜术的恢复时间. 接受TIVA-P治疗的患者经历了更短的麻醉后护理单位时间和更快的出院,但没有影响疼痛或满意度.
科学领域:
- 整形外科手术 整形外科手术
- 麻醉学 麻醉学
- 健行外科手术 健行外科手术
背景情况:
- 肩部关节镜检查通常使用在门诊外科中心 (ASC) 吸入全身麻醉 (IGA) 的间层阻塞.
- 使用普罗波福 (Propofol) 进行静脉内全麻醉 (TIVA-P) 是一种替代性麻醉技术,有可能在各种手术中缩短恢复时间.
研究的目的:
- 为了比较后麻醉护理单位第一阶段 (PACU-I) 患者接受肩膀关节透视术的患者之间的时间,使用间层阻塞和IGA与间层阻塞和TIVA-P.
- 评估两种麻醉方法之间PACU-I时间和其他恢复指标差异的临床意义.
主要方法:
- 一项随机研究涉及96名在ASC接受肩关节透视的患者,比较了IGA与TIVA-P的间层阻塞.
- 主要结局是PACU-I时间;次要结局包括疼痛,满意度,抗emetic使用,和总出院时间.
- 统计分析使用了奇平方和曼-惠特尼U测试,由于中间分析,显著性截止值为0.0167.
主要成果:
- 与IGA组 (25.5分钟;p <0.001) 相比,TIVA-P组的PACU-I中位时间显著缩短 (0.0分钟).
- 在TIVA-P组 (135.5分钟) 和IGA组 (148.5分钟;p = 0.0104) 中,排放的总时间也较短.
- TIVA-P与减少抗药的使用相关 (59.5%与92.5%相比; p = 0.0013) 在疼痛或满意度方面没有显著差异.
结论:
- 使用普罗波 (TIVA-P) 进行的静脉内全麻醉在减少PACU-I和肩部关节镜术的全排放时间方面具有潜在的优势.
- 在不影响患者疼痛控制或满意度的情况下,TIVA-P可能会降低抗要求.
- 在门诊外科中心,TIVA-P值得考虑肩部透镜手术.
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