头皮块的成本效益和有效性在资源有限的环境中选择性 supratentorial头骨切除术:一个随机对照试验
Chanatthee Kitsiripant1, Aunchitha Boonyamarn1, Maliwan Oofuvong1
1Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Surgical neurology international
|July 8, 2024
概括
在低收入和中等收入国家,芬太尼输液在神经外科疼痛管理方面比头皮阻塞更具成本效益. 虽然芬太尼更便宜,但整体麻醉成本和患者的结果需要仔细考虑,以获得最佳的疼痛控制.
科学领域:
- 麻醉学 麻醉学
- 神经外科 神经外科
- 卫生经济学 卫生经济学
背景情况:
- 雷米芬坦尼尔是治疗神经外科疼痛的首选药物,但在低收入和中等收入国家 (LMICs) 无法获得.
- 在LMICs中,头皮块是一种有效的替代方案,但其成本效益需要评估.
- 这项研究比较了头皮阻塞和芬太尼尔输液用于选择性脑膜切除术疼痛管理.
研究的目的:
- 为了比较头皮阻塞和芬太尼尔输液的麻醉成本.
- 评估外科手术期间的结果,包括阿片类药物消费,血液动力学变化和并发症.
主要方法:
- 这是一项前性,双盲,随机对照试验,涉及36名成年患者.
- 随机分配到头皮块 (S组) 或芬太尼尔输液 (F组).
- 主要终点:麻醉费用;次要终点:外科手术期间使用阿片类药物,血液动力学和并发症.
主要成果:
- 芬太尼的成本明显低于局部麻醉剂 (3.31美元对4.27美元).
- 总体麻醉成本在各组之间没有显著差异.
- 与头皮阻塞相比,芬太尼输液组显示了针插入后的平均动脉压降低.
结论:
- 芬太尼输液在神经外科疼痛的LMIC中提供了成本优势.
- 谨慎使用阿片类药物至关重要.
- 需要进一步的研究,以优化神经外科疼痛管理和长期安全.
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