挥发性麻醉剂使用与心脏门手术患者的静脉全内麻醉:全国人口研究
Jae-Woo Ju1, Ho-Jin Lee1, Karam Nam1
1From the Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Anesthesia and analgesia
|June 17, 2024
概括
与全静脉麻醉 (TIVA) 相比,挥发性麻醉剂没有降低心脏门手术后的死亡率. 这些患者的麻醉选择可能取决于提供者的偏好,而不是生存益处.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 公共卫生 公共卫生
背景情况:
- 由于心脏保护,建议使用挥发性麻醉剂来改善心脏手术的结果,而不是TIVA.
- 之前的研究得出了不确定的结果,对心脏门手术患者的数据有限.
研究的目的:
- 调查挥发性麻醉剂使用与心脏门手术后死亡率之间的关联.
- 为了在这个患者群体中比较挥发性麻醉剂和TIVA之间的长期和1年全因死亡风险.
主要方法:
- 基于韩国医疗保险数据的成年心脏门手术患者 (2010-2019) 的全国性基于人口的研究.
- 患者被分为挥发性麻醉或TIVA组.
- 稳定治疗加权的逆概率 (IPTW) 和考克斯回归分析被用于评估死亡风险.
主要成果:
- 该研究包括30755名患者;1年死亡率为8.5%.
- 在IPTW后,在挥发性麻醉剂和TIVA之间没有发现1年死亡风险的显著差异 (HR,0.98;95% CI,0.90-1.07).
- 长期死亡风险也没有显著的差异 (HR,0.98;95% CI,0.93-1.04) 经过4.8年的中位随访后.
结论:
- 与TIVA相比,挥发性麻醉剂的使用与心脏门手术患者的术后死亡风险降低无关.
- 研究结果表明,挥发性麻醉剂不会显著影响心脏门手术后的死亡率.
- 麻醉选择可以基于麻醉师或机构的偏好.
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