区域II曲肌修复在一般和醒局部麻醉下的结果:随机对照试验
Tarek Abdalla El-Gammal1, Waleed Riad Saleh2, Yasser Farouk Ragheb2
1Department of Orthopedics and Traumatology, Center for Hand and Reconstructive Microsurgery, Assiut University Hospitals and School of Medicine, Assiut, Egypt; Department of Orthopedics, University of Florida, Gainesville, FL.
The Journal of hand surgery
|August 8, 2024
概括
完全清醒的局部麻醉无护 (WALANT) 在II区曲肌修复方面没有表现出优于全身麻醉的优势. 两种麻醉方法之间的功能,破裂和患者满意度的结果是可比的.
科学领域:
- 整形外科手术 整形外科手术
- 麻醉学 麻醉学
- 手术手术手术手术手术
背景情况:
- 完全清醒的局部麻醉无护 (WALANT) 越来越多地用于曲肌修复.
- 一般麻醉 (GA) 是这些程序的传统方法.
研究的目的:
- 为了比较WALANT与GA在II区曲肌修复方面的疗效.
- 为了确定与GA相比,WALANT是否提供更优异的功能结果,更低的破裂率,或改善患者报告的结果.
主要方法:
- 一项随机对照试验包括86个数字接受了II区曲肌修复.
- 数字被随机分配到WALANT或GA,所有手术都由一名外科医生进行.
- 6个月后评估的结果包括功能恢复 (斯特里克兰和格洛格瓦克标准),破裂率,并发症和DASH分数.
主要成果:
- 分析包括WALANT组中的43个数字和GA组中的40个数字.
- 在49% (WALANT) 和56% (GA) 实现了优秀或良好的结果,这是非统计学上显著的差异.
- 断裂率相同 (每个组的两位数),平均DASH分数为12.9 (WALANT) 和8.4 (GA).
结论:
- 在功能,破裂率或患者报告的结果方面,WALANT在II区曲肌修复方面没有明显优于GA.
- 当通过仔细的患者选择,精确的手术技术和勤奋的手术治疗来支持时,WALANT和GA都是可行的选择.
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
601
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
601
General Anesthesia: Overview
199
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...
199
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
381
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
381
Local Anesthetics: Clinical Application as Epidural Anesthesia
427
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
427
Stages of General Anesthesia
399
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
399
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
999
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
999


