少数外科医生执行绝大多数不常见的神经减压手术
Niels Brinkman1, Sina Ramtin1, David Ring1
1Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
Clinical orthopaedics and related research
|June 21, 2024
概括
少数外科医生进行最不常见的神经手术,这表明在治疗手臂疼痛时要谨慎. 这突显了外科医生对患者选择的潜在影响.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 整形外科 整形外科 整形外科
背景情况:
- 在不常见的手术中,外科医生的变化可能表明专业知识集中或有问题的自由裁量程序.
- 对疼痛的任意手术,缺乏客观的病理生理学,引发了对外科医生的意见影响患者行为的担忧.
- 研究上肢外围单元神经病变手术的变化可以揭示有问题的做法.
研究的目的:
- 确定有多少高体积手腕道释放 (CTR) 外科医生也执行不太常见的外周神经释放 (PNRs) 或肘部道释放 (CubTRs).
- 分析外科医生执行的不太常见的PNR和CubTR的数量,范围和比例.
- 调查执行和不执行较少常见的神经减压的外科医生之间的性别,专业和手术体积的差异.
主要方法:
- 利用医疗保险数据 (2013-2019) 来识别每年执行≥10次CTR的外科医生.
- 5439名外科医生的计算年平均CTR,CubTR和不太常见的PNR.
- 进行和不进行较少的神经手术的外科医生人口统计和手术量进行比较.
主要成果:
- 只有2%的大量CTR外科医生每年执行≥1次较少的PNR;14%执行≥1次CubTR;1%执行两者.
- 执行不太常见PNR的外科医生每年平均进行7次PNR (5次CTR每1次PNR).
- 整形外科医生更有可能进行不常见的神经释放 (6%vs. 1%);性别不是一个重要的因素.
结论:
- 一个小组的外科医生执行大多数不常见的手臂疼痛神经手术,建议一般谨慎.
- 随意手术的高差异可能反映了外科医生对患者选择的影响,需要检查清单等保护措施.
相关概念视频
01:31Skeletal Muscle Relaxants: Therapeutic Uses
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
01:24General Anesthesia: Overview
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:30Psychosurgery
Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...