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一项前性研究比较广泛唤醒的局部麻醉没有围护与手部骨折固定中的全身麻醉

Shalimar Abdullah¹, Khairul Azmi Bin Ghazali², Elaine Zi Fan Soh¹

¹Hand and Microsurgery Unit, Department of Orthopaedics and Traumatology, Faculty of Medicine, Universiti Kebangasaan Malaysia, Kuala Lumpur, Malaysia.

Journal of hand surgery global online

|December 20, 2024

概括

用于手部骨折固定的广泛清醒局部麻醉无护 (WALANT) 提供与全身麻醉 (GA) 相比的疼痛缓解和功能结果. 沃兰特手术可能会导致更快的恢复,除了在手术后三个月外,功能得分相似.

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:

传统的手部骨折固定通常使用全身麻醉 (GA) 或区域麻醉.
使用带可以导致术后疼痛和不适.
完全清醒的局部麻醉无护套 (WALANT) 允许在没有护套的情况下对完全清醒的患者进行手术,从而使手术内功能评估成为可能.

研究的目的:

为了比较GA和WALANT之间手部骨折固定的外科参数和临床结果.
评估WALANT在手部骨折手术中的有效性和安全性.

主要方法:

一项涉及48名手部骨折患者的比较研究.
患者被分为两个组:21组接受GA,27组接受WALANT.
评估的参数包括生命体征,手术持续时间,血液损失,疼痛 (视觉模拟量表) 和功能结果 (快速DASH).

主要成果:

在WALANT组显示显著更高的静脉压和估计的血液损失.
在WALANT组中,手术时间较短,尽管并没有显著差异.
在手术后2小时和2周,WALANT组报告疼痛得分明显降低.

结论:

手部骨折的WALANT手术提供了与GA相比的 analgesic 效果和功能结果 (QuickDASH),在3个月后有明显的差异.
沃兰特是一种可行的GA替代品,用于手部骨折固定,可能改善患者舒适度,并允许立即功能评估.

关键词:

断裂固定方法断裂固定方法整体麻醉是一种全身麻醉.手部骨折手部骨折在手部骨折局部麻醉局部麻醉瓦伦特是一个伟大的人.

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