在内镜鼻外科手术中使用两种鼻膜制备方法后,麻醉后的恢复结果
Sinneary Meas1, Erin K O'Brien2, Janalee K Stokken2
1Nurse Anesthesia Program, Mayo Clinic School of Health Sciences, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America.
American journal of otolaryngology
|August 3, 2024
概括
局部可卡因与注射含有上腺素的利多卡因 (TCLE) 在内镜外科手术 (ESS) 期间用于鼻腔粘膜制备,与局部上腺素 (TE) 相比,导致疼痛不那么严重,恢复更快. 这表明TCLE可能有利于门诊ESS患者.
科学领域:
- 麻醉学 麻醉学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术创新 在外科创新.
背景情况:
- 透镜鼻手术 (ESS) 需要最佳的外科现场可视化.
- 为了实现这一目标,使用了包括局部上腺素 (TE) 和局部可卡因与利多卡因/上腺素注射 (TCLE) 在内的鼻腔粘膜制备技术.
- 对比这些制备方法的麻醉结果对于患者的康复至关重要.
研究的目的:
- 为了比较TE和TCLE之间的术后麻醉结果,用于ESS期间的鼻膜制备.
- 评估这些技术对疼痛,止痛药的使用和恢复时间的影响.
主要方法:
- 对1449名在全身麻醉下接受ESS的成年患者的回顾性分析.
- 在TE和TCLE组之间对麻醉结果 (疼痛,恢复时间) 的比较.
- 治疗权重的逆概率 (IPTW) 用于调整混因素.
主要成果:
- 与TE组相比,TCLE组的疼痛严重程度显著降低 (OR 0.65),并且需要较少的阿片类药物止痛药 (OR 0.55).
- 在TCLE组的患者在康复室停留时间较短 (比率为0.90).
- 手术后的恶心,吐和镇静在两组之间是相似的.
结论:
- 用TCLE进行鼻腔粘膜制备与在麻醉后康复室减少严重疼痛和阿片类药物使用有关.
- 对于接受ESS的患者来说,TCLE促进了更快的麻醉恢复.
- 这些发现表明TCLE为外科医院ESS患者提供了优势.
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