不同麻醉方法对内镜鼻手术出血和预后的影响:随机对照试验的元分析和系统审查
Xiaoquan Wei1, Mengsheng Yang1, Dan Li2
1Department of ENT, Gansu Provincial Hospital, Lanzhou, China.
Minerva anestesiologica
|July 14, 2025
概括
与吸入麻醉相比,静脉麻醉导致内科手术出血较少,内镜手术的手术时间较短. 然而,吸入麻醉可以减少术后的恶心和吐.
科学领域:
- 麻醉学 麻醉学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 基于证据的医学基于证据的医学.
背景情况:
- 内镜外科手术 (ESS) 是一种常见的手术.
- 麻醉选择可能会影响手术结果.
- 静脉 (IV) 和吸入麻醉是常见的方法.
研究的目的:
- 为了比较IV和吸入麻醉对ESS患者手术内出血和预后的影响.
- 综合来自随机对照试验 (RCT) 的证据.
主要方法:
- 在Cochrane图书馆,PubMed,Embase和科学网上进行系统搜索.
- 包括从1990年到2024年的RCT.
- 主要结局:手术内流血和外科现场出血分数.
- 二次结果:术后恶心,吐和疼痛.
- 使用风险比率和标准化平均差异的元分析.
主要成果:
- 包括26个RCT,包括1472名患者.
- 静脉麻醉与显著降低血损失 (SMD=0.69,P=0.005) 和更短的操作持续时间 (SMD=0.15,P=0.01) 相关.
- 手术场的出血得分偏好了静脉麻醉.
- 吸入麻醉显示手术后恶心和吐的风险较低 (RR=0.72,P=0.01).
- 年龄被确定为异质性的潜在来源.
结论:
- 静脉麻醉在减少手术内出血和缩短ESS手术时间方面具有优势.
- 吸入麻醉可能是最好的,以尽量减少术后恶心和吐.
- 个性化患者评估对于最佳的术后规划至关重要.
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