在清醒时进行的骨切除术对麻醉要求的影响:一项回顾性队列研究
Maria Luisa Machado Assis1, David S Sabsevitz2, Kiran S Merchant1
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Jacksonville, FL, USA.
Clinical neurology and neurosurgery
|February 11, 2026
概括
没有针固定的醒着骨切割 (AC) 显示头部运动增加,但罕见的破坏性事件. 这种方法可能为接受脑外科手术的患者提供工作流和舒适度的好处.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 手术创新 在外科创新.
背景情况:
- 醒着的骨切除术 (AC) 是精确切切地切除关键大脑区域的标准.
- 传统的AC使用头部固定针,可能导致患者的不适和生理压力.
- 这项研究比较了带针固定和不带针固定的AC的外术期结果.
研究的目的:
- 与传统的钉钉固定相比,评估没有钉钉固定的AC的安全性和有效性.
- 评估头部运动,麻醉要求,血液动力学,手术时间和恢复的差异.
主要方法:
- 从2018年10月到2023年6月接受AC的成年患者的回顾性队列研究.
- 术后结果的分析,包括头部运动,麻醉剂量 (propofol,dexmedetomidine),血液动力学,手术时间和恢复指标.
- 通过固定针的交流和没有固定针的交流之间的结果比较.
主要成果:
- 没有固定AC的头部运动较大 (p < 0.001),但不常见的破坏性事件 (等级4: 6%).
- 固定AC需要更高的propofol剂量 (p = 0.029) 并显示较大的缩血压增加 (p = 0.021).
- 没有钉钉的AC与更短的操作持续时间 (p = 0.001) 和类似的ICU停留时间有关.
结论:
- 没有针固定的AC显示出更大的头部移动性,但罕见的临床显著事件.
- 麻醉使用,血液动力学和手术时间的适度差异表明,对精心挑选的患者有潜在的益处.
- 需要进一步的前性,多中心研究来完善患者选择,并确认这些发现对于无针AC.
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