胸椎脊髓麻醉用于腹腔镜腹透析导管放置在老年高风险末期病患者
Maddalena Ricci1, Anna Rita Bonfigli2, Olga Protic2
1Unit of Nephrology and Dialysis, IRCCS-INRCA, Ancona, Italy.
概括
胸椎脊髓麻醉 (TSA) 为老年多病患者视频透视辅助腹膜透析导管安置提供了全身麻醉的安全替代方案. 这种方法可以减少与传统麻醉相关的风险,在这个脆弱的人群中.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 麻醉学 麻醉学
- 最少侵入性的手术
背景情况:
- 腹腔透析 (PD) 导管的放置是先前腹部手术或腹膜炎的患者的挑战.
- 在全身麻醉 (GA) 下的视频-镜辅助安置是标准的,但对老年多病患者构成风险.
- 一般麻醉 (GA) 的并发症是老年终端病 (ESKD) 患者的一个担忧.
研究的目的:
- 评估胸椎脊髓麻醉 (TSA) 的可行性和安全性,用于视频显微镜辅助 (VLS) PD导管放置在老年多病性ESKD患者中.
- 探索TSA作为高风险的PD导管插入手术候选人的GA的替代品.
主要方法:
- 五名老年多病症ESKD患者 (平均年龄79.6岁) 的病例系列具有高的并发症评分.
- 使用VLS辅助技术在T9-T10水平的胸脊麻醉 (TSA) 下进行的PD导管放置.
- 在TSA期间和之后对疼痛控制和周围手术副作用的评估.
主要成果:
- 在所有五名患者中,在TSA下使用VLS辅助技术实现了成功的PD导管安置.
- 据报道,疼痛控制最佳,没有观察到周围手术副作用.
- 这种手术在老年,多病症患者队列中被很好地容忍.
结论:
- 胸椎脊髓麻醉 (TSA) 似乎是VLS辅助PD导管放置在老年多病性ESKD患者的全身麻醉的安全和有效替代方案.
- 这种技术可能对由于年龄或虚弱而无法接受GA的患者特别有益.
- 需要进一步的研究来证实TSA在这种特定患者群体和程序中的有用性.
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