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在远端上肢外科手术中与其他区域麻醉技术相比,臂尾阻塞:系统性审查和元分析
Kristof Nijs1,2,3, Pieter 's Hertogen1,3,4, Simon Buelens1,3,4
1Department of Anesthesiology and Pain Medicine, Jessa Hospital, 3500 Hasselt, Belgium.
Journal of clinical medicine
|June 19, 2024
概括
手和手腕手术的区域麻醉 (RA) 显示出不同的疗效. 超声导向的尾阻塞提供与关节上阻塞相比的麻醉作用,但效果不如关节内阻塞.
科学领域:
- 麻醉学 麻醉学
- 手术手术手术手术手术手术手术手术手术手术
- 区域麻醉地区麻醉
背景情况:
- 有许多区域麻醉 (RA) 技术用于远端上肢手术.
- 对于手/手腕手术成功率和安全性的最佳RA方法尚不清楚.
研究的目的:
- 比较手臂结阻断疗效和麻醉与手和手腕手术的其他RA技术.
- 在阻塞后30分钟内评估适当的手术麻醉的主要结果.
主要方法:
- 在MEDLINE,EMBASE,Cochrane和CENTRAL数据库中进行系统搜索.
- 包括随机对照试验 (RCT),比较股阻塞与其他臂阻塞,外围神经阻塞,IV RA和WALANT.
- 对手术麻醉成功,阻断性能和发病时间的元分析.
主要成果:
- 在超声波引导的关和关上阻塞之间,麻醉成功率没有显著差异 (RR:0.94 [0.89,1.00]).
- 超声导向的关阻塞显示,在统计学上显著地,麻醉成功率低于内关节阻塞 (RR:0.92 [0.88,0.97]).
- 超声导向的内关节阻塞比关节阻塞快得多 (SMD: 0.74 [0.30, 1.17]).
结论:
- 根据患者,手术和操作人员因素来个性化RA选择.
- 超声波导向的关块可能是最喜欢的患者担心与块相关的副作用.
- 高异质性需要更强大的RCT来得出最终的结论.
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