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在接受初级全膝关节整形手术的患者中,脊椎和全身麻醉之间的血液动力学稳定性:一项回顾性研究

Thomas Jeandin¹, Eric Albrecht¹, Jean-Benoit Rossel²

¹Department of Anesthesia, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, chuv.ch.

Anesthesiology research and practice

|December 8, 2025

概括

脊髓麻醉 (SA) 在全膝关节整形术 (TKA) 期间提供更好的血液动力稳定性,而不是全身麻醉 (GA). 在SA的患者需要更少的北上腺素,这表明在这种常见的手术过程中改善了血压管理.

科学领域:

麻醉学麻醉学
整形外科手术整形外科手术
心血管生理学心血管生理学

背景情况:

膝盖全关节整形术 (TKA) 是一种普遍的手术程序.
在手术期间流血是TKA的潜在并发症.
在TKA期间血液动力学稳定对于患者的治疗结果至关重要.

研究的目的:

为了比较TKA期间的全身麻醉 (GA) 和脊髓麻醉 (SA) 之间的手术内血动力学稳定性.
评估需要血管压缩器支持的血液动力学不稳定性的发生率.
为了确定在TKA期间与血液动力学不稳定性相关的因素.

主要方法:

在10年的时间里,对接受初级TKA的成年患者进行了回顾性分析.
对接受GA与SA的患者进行比较.
主要结局:经手术内血动力学不稳定性,定义为对北上腺素输注的要求.
二次结局:以弗得林/烯剂量,血液损失,液体的使用.

主要成果:

脊柱麻醉 (SA) 与使用北上腺素的比率显著降低 (3.6%与GA的10.4%相比,p < 0.001).
在SA组 (19毫克与31毫克相比,p < 0.001) 观察到较低的以弗德林给药量.
在手术期间流失的血液和使用烯酸乙烯在不同组之间是相似的,而GA患者接受了更多的液体.

结论:

一般麻醉 (GA) 在初级TKA期间需要比脊髓麻醉 (SA) 更多的北上腺素.
在TKA期间,在脊髓麻醉 (SA) 下更好地保持了手术内血液动力稳定性.
在TKA患者中,神经轴麻醉技术可能是保持血液动力学稳定的首选方法.

关键词:

一般麻醉全身麻醉血液动力学不稳定性膝盖关节整形手术膝盖关节整形手术脊髓麻醉脊髓麻醉

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