患有阻塞性睡眠呼吸暂停的患者在门诊环境中接受手术镇静的不良事件:更新的系统性审查和元分析
Felicia Ceban1, Naomi Abayomi2, Aparna Saripella3
1Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Sleep medicine reviews
|December 10, 2024
概括
患有阻塞性睡眠呼吸暂停 (OSA) 的患者在手术镇静期间面临更高的风险. 这次审查发现,OSA患者的呼吸事件和呼吸道干预的几率显著增加.
科学领域:
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是一种常见的疾病,与周围手术风险增加有关.
- 在门诊程序镇静设置中量化这些风险对于患者安全至关重要.
- 现有的文献在对接受镇静治疗的OSA患者的不良事件进行系统评估方面存在差距.
研究的目的:
- 系统地审查和元分析OSA患者在门诊环境中接受手术镇静的手术前不良事件的风险.
- 将这些风险与没有OSA的患者进行比较.
- 为在镇静期间管理OSA患者提供基于证据的见解.
主要方法:
- 在2011年1月1日至2024年1月4日期间发表的研究的四个数据库中进行系统搜索.
- 纳入标准:成年OSA患者,在门诊环境中进行手术镇静,报告了手术前的不良事件,以及对照组.
- 主要结局:OSA患者与非OSA患者的手术前不良事件发生率.
主要成果:
- 分析了19项涉及27,973名患者的研究.
- 患有OSA的患者呼吸系统不良事件的几率显著增加 (OR 1.65,P=0.04).
- 在OSA患者中,需要呼吸道机动/干预的几率显著增加 (OR 3.28,P=0.005).
- 在OSA患者中没有观察到心血管不良事件的显著增加.
结论:
- 接受门诊手术镇静的OSA患者面临更高的风险.
- 在OSA患者中,呼吸系统不良事件的几率增加了1.7倍.
- 需要呼吸道机动/干预的可能性增加了3.3倍,这凸显了OSA患者的关键安全问题.
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