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持续神经轴痛解的标准与进行胸切除术的患者的死亡率降低有关

Axel Semmelmann¹, Wolfgang Baar², Isabelle Moneke³

¹Department of Anesthesiology and Critical Care, Universitätsklinikum Freiburg, Freiburg, Germany axel.semmelmann@uniklinik-freiburg.de.

Regional anesthesia and pain medicine

|August 17, 2024

概括

持续的神经轴疼痛缓解,包括胸部外周和副脊椎阻塞,可能会降低选择胸部手术患者的术后死亡率,特别是老年人和患有并发病的人.

科学领域:

麻醉学麻醉学
胸部外科手术胸部外科手术
关键护理医学关键护理医学

背景情况:

胸部外周止痛疗法 (TEA) 和胸部副脊椎止痛疗法 (TPA) 是经过胸部手术后确立的疼痛管理技术.
这些技术旨在控制疼痛并减轻生理应激反应.
持续的神经轴技术被假设可以降低胸切除术后的术后死亡率.

研究的目的:

调查持续神经轴麻醉与开放胸切除术后住院死亡率之间的关联.
确定特定的患者亚组,这些患者可能会从神经轴麻醉中获得更大的好处.

主要方法:

来自德国胸腔注册局的1620名接受开放胸切除术的患者的回顾性分析.
在带有和没有神经轴麻醉的患者之间比较所有原因的住院患者死亡率.
后勤回归分析以调整混变量.

主要成果:

单变量分析显示神经轴痛解的死亡率较低 (2.9%与5.3%,p=0.02),但这在多变量分析中没有显著意义 (OR 0.49,p=0.15).
在以下子组中观察到显著的死亡率降低:年龄>75 (OR 0.1),ASA得分>III (OR 0.32),慢性脏疾病 (OR 0.16) 和术后败血症 (OR 0.13).

结论:

神经轴止痛技术与接受开放胸部手术的特定患者群体的术后死亡率降低有关.
这些益处在老年患者,那些ASA得分较高,慢性病或术后败血症患者中最为明显.

关键词:

止痛药止痛药止痛药是一种止痛药.麻醉,局部麻醉,局部麻醉结果就是结果.疼痛管理疼痛管理疼痛,术后的疼痛,术后的疼痛.

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