局部麻醉用1%的利多卡因与通用麻醉用于L5/S1椎间板的皮肤内镜间膜椎间板切除术:一项前性随机研究
Xin Wang1, Junjie Shen, Zhiheng Chen
1Department of Orthopedics, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
用1%的利多卡因进行局部麻醉是一种安全有效的替代全身麻醉,用于L5/S1.1.处的皮肤内镜腰椎切除术 (PEID). 这种方法减少了手术时间,康复时间和医疗费用,使其成为患者的首选选择.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 脊柱外科手术 脊柱外科手术
背景情况:
- 在L5/S1段的皮肤内镜腰椎切除术 (PEID) 经常使用全身麻醉 (GA).
- 由于有限的手术内监测,GA引发了对神经损伤的担忧.
- 局部麻醉 (LA) 是一个新兴的替代方案,但其在PEID的最佳使用仍在争论中.
研究的目的:
- 为了比较局部麻醉 (1%利多卡因) 与L5/S1水平的PEID全身麻醉的疗效和安全性.
- 评估手术参数,临床结果和与每个麻醉类型相关的并发症.
主要方法:
- 一项前性随机临床试验,涉及103名患有L5/S1盘的患者,正在接受PEID.
- 患者被随机分为两个组:局部麻醉 (n=53) 或全身麻醉 (n=50).
- 随访延长至至少24个月,比较手术时间,恢复,疼痛评分 (VAS),功能结果 (ODI,MacNab标准) 和并发症.
主要成果:
- 局部麻醉组的手术和床上休息时间显著缩短 (P<0.001).
- 局部麻醉导致住院费用较低 (P<0.001),但估计血液损失较高 (P<0.001).
- 两组之间没有观察到VAS,ODI或MacNab标准的显著差异;然而,LA发生的术后神经病变异常较少.
结论:
- 局部麻醉 (1%的利多卡因) 和全身麻醉对于L5/S1.1.的PEID都是安全有效的.
- 建议使用局部麻醉,因为手术时间缩短,床上休息时间缩短,经济成本降低.
- 虽然有效,但LA组中的一些患者需要手术内止痛,这表明需要仔细的疼痛管理.
更多相关视频
05:50A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
03:24Author Spotlight: Development and Application of a Novel Suture Technique for Annular Fibrosus Repair in Percutaneous Transforaminal Endoscopic Discectomy
Published on: January 26, 2024
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
Local Anesthetics: Clinical Application as Epidural Anesthesia
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...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Local Anesthetics: Differential Sensitivity of Nerve Fibers
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
