创伤手术中的碳足迹,有没有办法减少它?
Elize W Lockhorst1,2, Philip M J Schormans3, Cornelis A S Berende3
1Department of Surgery, Amphia Hospital, Molengracht 21, 4818 CK, Breda, The Netherlands. elockhorst@amphia.nl.
Journal of anesthesia, analgesia and critical care
|July 17, 2024
概括
切换创伤手术从全身麻醉到区域麻醉显著减少了sevoflurane的使用,减少了对环境的影响. 与全身麻醉相比,区域麻醉也显示出较低并发症率的趋势.
科学领域:
- 麻醉学 麻醉学
- 环境健康 环境健康
- 创伤外科 手术 创伤外科
背景情况:
- 吸入麻醉剂,如sevoflurane,对医疗保健的碳足迹做出了重大贡献.
- 建议尽量减少sevoflurane的使用,但在创伤手术中普遍使用全身麻醉.
- 区域麻醉为许多创伤手术提供了替代方案.
研究的目的:
- 评估区域麻醉与创伤手术中的全身麻醉对环境的益处.
- 为了比较创伤患者的区域和全身麻醉之间的并发症率.
主要方法:
- 对手,手腕,部或脚骨折进行手术的创伤患者 (≥18岁) 的回顾性研究 (2017-2021年).
- 计算假设的环境效益,假设所有手术都使用区域麻醉.
- 区域麻醉和全身麻醉组之间的并发症率比较.
主要成果:
- 在2,714次创伤手术中,95%使用全身麻醉;5%使用区域麻醉.
- 切换到区域麻醉可以减少92kg的sevoflurane使用,相当于406,553公里的汽车旅行.
- 综合症发生率在全身麻醉 (7.7%) 时高于区域麻醉 (6.9%),尽管在统计学上不显著 (p=0.75).
结论:
- 通过减少在创伤手术中使用sevoflurane来实现显著的环境效益,适用于区域麻醉.
- 区域麻醉为特定创伤手术提供了一个可行的,潜在的更安全的替代方案.
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