只有区域麻醉在抗凝固剂部骨折患者中是一个安全的选择吗?
Carolyn Herbosa1,2, Christopher Petit1, Sanjit Konda1,2
1New York University Langone Orthopedic Hospital, New York, United States.
概括
侧骨皮肤和部 (LOH) 块是抗凝固骨折患者的安全有效的区域麻醉剂. 它提供了可比的手术内安全性,与脊髓麻醉相比,减少了手术延迟,以及与全身麻醉相比,改善了放疗结果.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 创伤护理 创伤护理
背景情况:
- 部骨折在接受抗凝血药的患者中带来了重大挑战.
- 区域麻醉的选择对于管理术后风险至关重要.
研究的目的:
- 评估侧腿部皮肤和部 (LOH) 块在抗凝固骨折患者的安全性和有效性.
- 为了将LOH阻断结果与全身麻醉 (GA) 和脊髓麻醉 (SA) 进行比较.
主要方法:
- 135名接受抗凝血治疗的关节骨折患者的回顾性审查 (AO/OTA 31A/B).
- 根据麻醉分组的患者:LOH阻断,GA或SA.
- 根据抗凝剂类型,骨折分类和风险得分匹配的LOH患者 (3: 1 GA, 1: 1 SA).
主要成果:
- 与GA (0.89对1.31小时) 和SA (0.89对1.54小时) 相比,LOH阻断显示手术的时间更短.
- 较低的90天再入院率对于LOH与GA (3.7%与19.8%).
- 改善了LOH与GA (33.3%与8.6%) 获得医疗服务的家庭出院率.
结论:
- LOH阻塞是抗凝固剂关节骨折患者安全有效的麻醉选择.
- LOH 块提供与其他麻醉技术相似的手术内安全性.
- 与GA相比,LOH块改善了排放参数,与SA相比,减少了手术延迟.
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