以中枢神经轴阻塞进行逆行性内手术与全身麻醉相比:系统性审查和元分析
Amit Jagannath Patil1, Aashutosh Ramakant Patel1, Bhanupriya Shivshankar Pande2
1Department of Anaesthesiology, ACPM Medical College, Dhule, Maharashtra, India.
Saudi journal of anaesthesia
|April 24, 2024
概括
中枢神经轴阻塞 (CNB) 是用于逆行性内手术 (RIRS) 的全身麻醉 (GA) 的可行替代方案. 研究显示,结果没有显著差异,这表明,由于潜在的经济利益,CNB可能是可取的.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 麻醉学 麻醉学
- 基于证据的医学基于证据的医学.
背景情况:
- 逆行性内手术 (RIRS) 是一种常见的结石去除手术.
- 全身麻醉 (GA) 是RIRS的标准麻醉技术.
- 中枢神经轴阻塞 (CNB) 提供了一个潜在的替代麻醉方法.
研究的目的:
- 系统地审查和元分析CNB与GA对RIRS的影响.
- 为了比较关键的结果,包括手术时间,石头清除,疼痛和住院.
主要方法:
- 12项研究 (2018-2023) 的系统综述和元分析.
- 包括脊柱麻醉 (SA),外围麻醉 (EA) 和与GA结合的脊柱外围麻醉 (CSEA) 的比较研究.
- 在主要的电子数据库中搜索相关文献.
主要成果:
- 麻醉技术显著影响了手术时间 (平均差异 -2.28分钟有利于CNB,P=0.003).
- 在石头清除率,24小时疼痛得分或住院时间长度方面,在CNB和GA之间没有发现显著差异.
- 两种麻醉方法之间的并发症率也相似.
结论:
- 中枢神经轴阻塞 (CNB) 是对RIRS的全身麻醉 (GA) 的可行的替代方案.
- CNB为RIRS提供了与GA可比的疗效和安全性,并具有潜在的经济优势.
- 在CNB和GA之间进行选择时,应考虑患者的偏好,石头负担和基线特征.
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