血液瘤阻断是减少关闭前臂骨折的最有效的技术:一项回顾性队列研究
Georgia Rose Pitman1, Torgrim Soeyland2, Gordana Popovic3
1Hunter New England Local Health District, New Lambton, New South Wales, Australia.
Emergency medicine journal : EMJ
|July 17, 2024
概括
血液瘤阻断剂 (HB) 是减少前臂骨折的最有效麻醉剂,提供更短的ED停留时间和更低的成本. 虽然手术镇静 (PS) 的成功率更高,但HB导致并发症更少,非常适合资源有限的环境.
科学领域:
- 整形外科手术 整形外科手术
- 紧急医疗 紧急医疗
- 麻醉学 麻醉学
背景情况:
- 前臂骨折是急诊室 (ED) 经常出现的情况.
- 对关闭前臂骨折减少的麻醉技术进行比较对于资源管理至关重要.
研究的目的:
- 为了比较ED前臂骨折减少的三种麻醉技术的资源利用:血瘤阻断 (HB),比尔阻断 (BB) 和手术镇静 (PS).
主要方法:
- 在澳大利亚两家EDS进行了回顾性多中心队列研究 (2018年1月 - 2021年6月).
- 包括接受关闭前臂骨折减少术的成年患者.
- 与ED停留时间 (LOS) 的比较,首次减少成功,专家人数,人员利用率,耗材成本和并发症.
主要成果:
- 平均ED LOS在HB (187.7分钟) 与BB (227.2分钟) 和PS (239.3分钟) 中最低.
- 程序性镇静 (PS) 需要更多的ED专家,并且第一次尝试成功率 (94.4%) 比HB (76.2%) 和BB (88.6%) 高.
- 与PS (17.8%) 和BB (14.3%) 相比,血瘤阻断 (HB) 的成本更低,并发症更少 (13.1%).
结论:
- 血液瘤阻断 (HB) 是最有效的技术,提供更短的ED LOS,降低成本和更低的员工资源利用率.
- 尽管成功率更高,但程序性镇静 (PS) 有更多的并发症.
- 资源有限的ED应该优先考虑HB或BB来减少骨折,将PS保留在区域块失败或禁用的情况下.
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