脊柱麻醉在ASA III和IV身体状况儿科患者:一个回顾性审查
Nahida Akhter1, Edison E Villalobos1, Sibelle Aurelie Yemele Kitio1
1Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, Connecticut.
Saudi journal of anaesthesia
|February 19, 2026
概括
脊髓麻醉 (SA) 是高风险儿科患者 (ASA III/IV) 的全身麻醉 (GA) 的安全有效替代方案. 这项研究发现,在这种脆弱人群中,SA的成功率很高,并发症最小.
科学领域:
- 麻醉学 麻醉学
- 儿科手术 儿科手术
- 关键护理医学 关键护理医学
背景情况:
- 总麻醉 (GA) 带有风险,特别是对于具有重大并发症的患者.
- 脊柱麻醉 (SA) 是减轻这些风险的潜在替代方案.
- 高风险患者,被归类为美国麻醉学会 (ASA) 身体状态III和IV,需要仔细考虑麻醉.
研究的目的:
- 追溯审查脊柱麻醉 (SA) 的使用在被归类为ASA物理状态III和IV的儿科患者中.
- 评估SA的安全性和有效性作为GA的替代品在这个高风险队列中.
- 在这个人群中确定与SA相关的手术内不良事件和结果.
主要方法:
- 在2016年至2023年期间接受SA的儿科患者 (ASA III/IV) 的回顾性图表审查.
- 收集的数据包括患者人口统计,麻醉细节,手术程序和不良事件.
- 分析的重点是SA的成功率,并发症和转换到GA的原因.
主要成果:
- 在61名评估的儿科患者中,脊柱麻醉 (SA) 在88%的患者中成功 (ASA III/IV).
- 常见的并发病包括心脏,呼吸道,遗传和脏疾病.
- 最常见的手术内不良事件是短暂的低血压 (25%),没有血管活性剂进行管理;9.8%返回ED,没有一个是由于麻醉原因.
结论:
- 脊髓麻醉 (SA) 是安全有效的替代全身麻醉 (GA) 儿科患者与ASA身体状态III/IV.
- 手术后并发症的发病率低,支持SA在高风险手术候选人的安全性.
- 在复杂的儿科病例中,SA可以成功地被使用,提供一种可行的麻醉选择.
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