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脊柱麻醉失败的发生率和预测因素:系统性审查和元分析

Sitotaw Tesfa Zegeye¹, Belete Muluadam Admassie², Esubalew Muluneh Aligaz¹

¹Department of Anesthesia, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.

Patient safety in surgery

|November 28, 2025

概括

脊柱麻醉的失败率为8.36%. 影响脊柱麻醉失败的关键因素包括麻醉剂量,提供者经验和患者特征,强调需要标准化技术和培训.

科学领域:

麻醉学麻醉学
区域麻醉地区麻醉
基于证据的医学基于证据的医学.

背景情况:

脊柱麻醉是一种常见的区域技术,有可能失败.
失败可能会导致患者的不适,并需要使用替代麻醉方法.

研究的目的:

系统地审查和分析脊柱麻醉失败的综合发病率.
为了确定与脊髓麻醉失败相关的重要因素.

主要方法:

在PROSPERO (CRD420251101582) 中预期注册.
从2015年1月到2025年5月,在主要数据库 (PubMed,Embase,Cochrane,Web of Science,Google Scholar) 中进行全面的文献搜索.
随机效应模型元分析以确定预测因素的聚合发病率和赔率比率,以I2统计评估异质性.

主要成果:

对21项涉及44790名参与者的研究进行了分析.
脊髓麻醉失败的综合发病率为8.36% (95% CI:6.94-9.78).
确定了重要的预测因素:局部麻醉剂的度和剂量,提供者缺乏经验,有血的大脑脊髓液,紧急手术,麻醉史,BMI,L4-L5穿孔部位和缺席的CSF自由流动.

结论:

脊柱麻醉失败发生在一个显著的速度.
标准化技术,优化麻醉剂量和持续训练对于降低失败率至关重要.
解决已识别的相关因素是改善脊柱麻醉成功的关键,特别是在资源有限的环境中.

关键词:

失效率是因为失效率.预测者预测者区域麻醉地区麻醉脊髓麻醉脊髓麻醉

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