一般和区域麻醉在下肢截肢的术后结果
Shannon M McDonnell1, Rylie O'Meara2, Irena Helenowski3
1Division of Vascular Surgery and Endovascular Therapy, Loyola University Chicago, Stritch School of Medicine, Loyola University Health System, Chicago, IL; Division of Vascular Diseases and Surgery, The Ohio State University Medical Center, Columbus, OH.
与全身麻醉相比,区域麻醉阻断显著降低了下肢截肢的死亡率. 这项研究强调了区域区块对改善患者治疗结果的好处.
科学领域:
- 血管外科 血管外科
- 麻醉学 麻醉学
- 外科手术的结果
背景情况:
- 截肢是关键的血管外科手术程序.
- 全身麻醉是常见的,但区域麻醉可能会减少术后发病率.
- 目前的数据表明,尽管区域麻醉具有潜在的益处,但其利用率不足.
研究的目的:
- 为了比较下肢截肢的全身麻醉和区域麻醉之间的手术结果.
- 评估麻醉类型对患者发病率和死亡率的影响.
- 为了确定区域麻醉是否比全身麻醉提供了显著的优势.
主要方法:
- 对176个下肢截肢的回顾性队列研究 (2019-2023年).下肢截肢.
- 患者被分为三组:仅限区域阻断,阻断的全身麻醉和仅限全身麻醉.
- 分析包括患者特征,并发症和术后结果,使用概括估计方程和多变量模型.
主要成果:
- 只有全身麻醉的组显示肺栓塞,深静脉血栓,肺炎和呼吸机使用率较高.
- 接受全身麻醉的患者只经历了更长的住院时间和增加的死亡率 (30天,60天,1年).
- 区域块使用与老年患者和心力衰竭,病和糖尿病的更高率有关.
结论:
- 下肢截肢的全身麻醉独立地与死亡率的增加有关.
- 建议转向使用区域块用于下肢截肢.
- 区域麻醉可能是一个更安全的替代方案,特别是对于高风险患者.
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