将军对阵将军 区域麻醉:在关节镜膝关节手术中对术后焦虑,抑郁和压力生物标志物的差异影响:一项随机临床试验
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Congcong Huang1,2, Chunwei Lian1,2, Yu Che3
1Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
International journal of surgery (London, England)
|December 9, 2025
概括
与区域麻醉 (RA) 相比,全身麻醉 (GA) 导致前十字带重建 (ACLR) 患者的术后焦虑降低. 风湿性关节炎表现出优异的外科手术期间唾液皮质醇 (SC) 抑制,但SC并没有调解焦虑水平.
科学领域:
- 整形外科手术 整形外科手术
- 麻醉学 麻醉学
- 心理学 心理学 心理学
背景情况:
- 前十字带重建 (ACLR) 是一种常见的骨科手术.
- 手术后的焦虑和/或抑郁症 (PAD) 可能会影响患者的康复.
- 一般麻醉 (GA) 和区域麻醉 (RA) 之间的选择可能会影响心理结果.
研究的目的:
- 为了比较GA与RA在关节镜ACLR后对PAD的影响.
- 调查唾液皮质醇 (SC) 和α-氨基酶 (sAA) 在这种关系中的潜在调解作用.
主要方法:
- 一项前性随机试验,涉及82名接受ACL重建的患者.
- 主要结局的比较:PAD,SC,sAA和血糖水平.
- 其次结果包括疼痛,胀,阿片类药物消费和住院治疗.
主要成果:
- 在多个时间点,RA组的术后焦虑明显高于GA组 (p < 0.000 到 0.001).
- 在手术后,GA组的唾液皮质醇 (SC) 水平明显高于RA组 (p < 0.001 到 0.012).
- 两组之间没有发现术后抑郁症,SAA或血糖水平的显著差异.
结论:
- 一般麻醉 (GA) 与ACLR患者的手术后焦虑程度较低有关.
- 区域麻醉 (RA) 与高级外科手术期间的唾液皮质醇 (SC) 抑制有关.
- SC没有调解麻醉技术和术后焦虑之间的关联,这表明GA可能是焦虑易感患者和RA压力敏感个体的首选.
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