在全身和神经轴麻醉下进行最小侵入性结肠直肠手术:回顾性倾向-得分-匹配分析
Carlo Ferrari1, Jacopo Crippa1, Davide Vailati2
1Division of General Surgery, Vizzolo Predabissi Hospital, ASST Melegnano e Martesana, via Pandina 1, Vizzolo Predabissi, 20077 Milan, Italy.
Journal of clinical medicine
|November 13, 2025
概括
神经轴麻醉为最小侵入性结直肠手术提供了全身麻醉的可行替代方案. 这种方法需要更长的准备时间,但可以缩短操作时间,而不会增加并发症.
科学领域:
- 麻醉学 麻醉学
- 结肠直肠手术 结肠直肠手术
- 最少侵入性的手术
背景情况:
- 神经轴麻醉 (结合脊柱-外皮麻醉) 是对微创性结直肠手术的潜在替代方案.
- 现有的证据仅限于案例系列,缺乏队列研究.
研究的目的:
- 为了比较神经轴麻醉与全身麻醉的微创性结直肠手术.
- 评估麻醉和手术结果,包括并发症.
主要方法:
- 对接受微创结直肠手术的患者的回顾性分析 (2022年10月至2024年10月).
- 使用倾向得分匹配进行神经轴和全身麻醉组之间的比较.
- 评估准备时间,手术持续时间,ICU入院,住院和90天的术后并发症.
主要成果:
- 神经轴麻醉组在匹配后的准备时间较长 (42.5分 vs. 30分钟),但手术时间较短 (181分 vs. 231分钟).
- 不需要从神经轴向转换为全身麻醉.
- 住院时间和并发症率 (包括静脉漏和再入院) 在两组之间是可比的.
结论:
- 神经轴麻醉可能是微创性结直肠手术的安全有效替代方案.
- 它与更长的麻醉制备相关,但手术时间更短.
- 需要进一步的研究来探索其在结直肠手术中的应用.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
532
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
532
General Anesthesia: Overview
556
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
556
Local Anesthetics: Clinical Application as Spinal Anesthesia
1.3K
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
1.3K


