视频辅助胸部切除术后的麻醉技术和术后肺部并发症 (PPC):一个回顾性观察队列研究
Priyanka Singla1, Brian Brenner1, Siny Tsang1
1Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, United States of America.
PloS one
|December 4, 2024
概括
将区域或局部麻醉添加到VATS叶切除术的全身麻醉中并没有减少肺部并发症,但确实缩短了住院时间. 需要进一步的研究来优化麻醉技术,以便在胸部手术后更好地恢复.
科学领域:
- 胸部外科手术 胸部外科手术
- 麻醉学 麻醉学
- 肺部医学 肺部医学
背景情况:
- 手术后肺部并发症 (PPC) 影响8-10%的胸部手术患者.
- 视频辅助胸腔镜手术 (VATS) 旨在减少并发症,但PPC仍然存在.
- 在VATS程序后,PPC是导致发病的重要原因.
研究的目的:
- 为了评估不同麻醉技术在VATS叶切除术后对PPC的影响.
- 为了确定组合麻醉方法是否减少PPCs与单独全身麻醉相比.
- 评估麻醉技术对VATS脑膜切除术后住院时间 (LOS) 的影响.
主要方法:
- 来自ACS-NSQIP数据库 (2017-2021) 的14477例VATS叶切除术病例的分析.
- 病例分为四个麻醉组:单独全身麻醉 (GA),GA+局部,GA+区域和GA+外周麻醉.
- 一般化的线性回归模型用于比较PPC率和LOS,控制风险因素.
主要成果:
- 整体PPC率在3.5-5.2%之间,麻醉组之间没有显著差异.
- 与单独GA相比,GA+区域性和GA+局部麻醉与显著更短的LOS相关 (分别减少9.1%和5.5%).
- GA+外周麻醉与显著更长的LOS相关 (18%的增加).
结论:
- 结合区域或局部麻醉与GA的麻醉技术在VATS叶切除术后不会减少PPC.
- 这些组合技术,特别是区域和地方技术,与更短的住院时间有关.
- 进一步的随机对照试验是有必要的,以确定最佳的麻醉策略来治疗疼痛和恢复.
相关概念视频
Endoscopic Studies II: Thoracocentesis
199
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
199
Endoscopic Studies I: Bronchoscopy and Thoracoscopy
173
Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
173
Inhalational Anesthetics: Overview
192
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
192
Pneumothorax-II
120
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
120
General Anesthesia: Overview
192
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...
192
Endotracheal Intubation II: Nursing Management
479
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
479


