在整形外科手术中,是否与降低对低压麻醉的需求有关?
Timothy M Weber1, Brendan Squier2, Brian E Kinard3
1Resident, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham School of Dentistry, Birmingham, AL.
概括
特兰胺酸 (TXA) 有效地保持了手术的可见性,并控制了在没有低血压麻醉 (HA) 的bimaxillary orthognathic手术中的血液损失. 这表明TXA可能会减少对HA的需求,最大限度地降低相关风险,并可能降低医疗保健成本.
科学领域:
- 口腔和牙面部外科手术
- 麻醉学 麻醉学
- 外科手术静血 静血是什么
背景情况:
- 低血压麻醉 (HA) 在整形手术中用于减少血液损失,但会带来低输血的风险.
- 众所周知,胺酸 (TXA) 能减少出血,但其在没有HA的情况下在骨架外科手术中的孤立作用尚未得到充分研究.
- 评估没有HA的TXA可能会揭示其有效性,使HA成为不必要的风险.
研究的目的:
- 为了评估手术部位的可视化在 bimaxillary orthognathic 手术期间.
- 在接受TXA而没有故意HA的患者中测量血液损失.
- 为了确定单独的TXA是否足以在这种手术背景下控制血液损失.
主要方法:
- 对115名患者 (14-75岁) 的前性队列研究,这些患者接受了用TXA进行的双轴直视手术.
- 根据低血压麻醉下时间的百分比 (<10%与>10%),患者被分为两组.
- 使用手术现场可见度,估计的血液损失以及血红蛋白和血红素水平的变化来评估血液损失.
主要成果:
- 在手术现场可见性方面,两组之间没有发现统计学上显著的差异.
- 估计的血液损失,血红蛋白和血红素值变化在低 (<10%) 和高 (>10%) 低压麻醉暴露之间没有显著差异.
- 所有主要结果变量的P值都大于0.1,表明没有统计学意义上的关联.
结论:
- 特兰胺酸 (TXA) 在正常压力条件下有效地保持手术可见性,并控制在双轴性整形外科手术期间的血液流失.
- 与TA相比,使用TXA的常压麻醉可能会节省成本,提高效率.
- 这些发现表明,有可能减少对HA的依赖,但需要进行随机对照试验来确认.
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