耳植入器的个性化麻醉策略:从单个机构的经验中了解局部麻醉的见解
Chang-Hee Kim1, Jung Kyu Lee2, Hye-Rim Park2
1Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul.
概括
在局部麻醉下进行耳植入 (CI) 对于某些高风险成年人来说是安全的. 量身定制的方案,特别是对于线粒体疾病,改善了听力康复的结果.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 麻醉学 麻醉学
- 医学遗传学 医学遗传学
背景情况:
- 耳植入器 (CI) 是严重听力损失的关键干预措施.
- 高风险的成年患者通常需要对CI进行仔细的麻醉管理.
- 局部麻醉 (LA) 与镇静是一种潜在的替代全身麻醉 (GA).
研究的目的:
- 评估CI在LA下的可行性和安全性,在高风险成年人中提供最小的镇静.
- 建立在这个患者群体中选择麻醉的机构标准.
- 为了探索患有特殊疾病的患者的结局,如MELAS综合征.
主要方法:
- 在2021年1月至2025年2月期间,在LA下进行的17例CI病例的回顾性审查,在最低限度的镇静下进行LA.
- 应用标准化的机构协议,包括手术前咨询和有针对性的麻醉.
- 监测完成率,转换为GA,以及术后并发症.
主要成果:
- 在LA下成功完成CI的94.12% (16/17耳).
- 由于与认知障碍相关的行为问题,一个转换为GA.
- 没有术后死亡率或重大并发症;MELAS综合征是常见的适应症.
结论:
- 在LA下的CI对于精心挑选的高风险成年患者来说是可行的和安全的选择.
- 个性化麻醉方案至关重要,特别是对于那些患有线粒体疾病或认知弱点的人来说.
- 这种方法支持优化听力康复结果.
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