Perspectives on Analgesia for Craniotomy: A Survey of Anesthetic Practices.

IF 2.3 2区 医学 Q2 ANESTHESIOLOGY
Anita Vincent, Mark A Burbridge, Nophanan Chaikittisilpa, Indranil Chakraborty, Michelle Chong, Tumul Chowdhury, Paul Garcia, John G Gaudet, Taniga Kiatchai, Hemanshu Prabhakar, Ananya A Shiferaw, Gentle S Shrestha, Peter C S Tan, Cristiane Tavares, Susana Vacas, Samuel N Blacker, Abhijit V Lele, Jorge Mejia-Mantilla
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引用次数: 0

Abstract

Background: This study aimed to compare analgesic practices for patients undergoing craniotomy in high-income countries (HICs) and low-income and middle-income countries (LMICs), focusing on variations in medication use and techniques.

Methods: An English-language and Spanish-language electronic survey was sent to over 300 anesthesiologists in 35 countries from March 22 to May 19, 2024, to gather data on analgesia for craniotomy patients. Anonymous responses through REDCap were analyzed as a whole and by income category (HICs and LMICs).

Results: We received 328 responses (105 HICs, 221 LMICs, and 2 missing locations). Acetaminophen was used by 78% of respondents (HIC: 82%, LMIC: 76%), with low nonavailability in both groups (0.95% HICs, 4.98% LMICs). Fentanyl boluses were used in 57% of cases (HIC: 60%, LMIC: 55%). Incisional local anesthesia was administered in 51% (HIC: 52%, LMIC: 50%), with minimal nonavailability (1.9% HIC, 1.4% LMIC). The use of a remifentanil infusion was more common in HICs (64%) than LMICs (31%), where nonavailability was significantly higher (43.89% vs. 7.62% HICs). Scalp blocks were used by 15% of HICs and 43% of LMICs. Craniotomy indication influenced the choice of analgesia for 61% of respondents.

Conclusions: Analgesic practices for craniotomy vary significantly between HICs and LMICs, primarily due to medication availability. Global guidelines should consider resource differences to improve postoperative pain management.

开颅手术镇痛的展望:麻醉实践综述。
背景:本研究旨在比较高收入国家(HICs)和低收入和中等收入国家(LMICs)接受开颅手术患者的镇痛做法,重点关注药物使用和技术的差异。方法:于2024年3月22日至5月19日对35个国家的300多名麻醉师进行英语和西班牙语电子调查,收集开颅手术患者的镇痛数据。通过REDCap对匿名回复进行整体分析,并按收入类别(高收入国家和低收入国家)进行分析。结果:我们收到328份回复(高收入国家105份,低收入国家221份,缺失地点2份)。78%的受访者(高收入人群:82%,低收入人群:76%)使用对乙酰氨基酚,两组的不可用性都很低(高收入人群:0.95%,低收入人群:4.98%)。57%的病例使用芬太尼丸(HIC: 60%, LMIC: 55%)。51%的患者采用切口局麻(HIC: 52%, LMIC: 50%),极少患者无法获得切口局麻(HIC 1.9%, LMIC 1.4%)。使用瑞芬太尼输液在高收入国家(64%)比低收入国家(31%)更常见,后者的不可用性明显更高(43.89%对7.62%高收入国家)。15%的高收入人群和43%的低收入人群使用头皮阻滞。61%的应答者认为开颅指征影响了镇痛药的选择。结论:高收入国家和低收入国家开颅手术的镇痛做法存在显著差异,主要是由于药物可得性不同。全球指南应考虑资源差异,以改善术后疼痛管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.20
自引率
10.80%
发文量
119
审稿时长
>12 weeks
期刊介绍: The Journal of Neurosurgical Anesthesiology (JNA) is a peer-reviewed publication directed to an audience of neuroanesthesiologists, neurosurgeons, neurosurgical monitoring specialists, neurosurgical support staff, and Neurosurgical Intensive Care Unit personnel. The journal publishes original peer-reviewed studies in the form of Clinical Investigations, Laboratory Investigations, Clinical Reports, Review Articles, Journal Club synopses of current literature from related journals, presentation of Points of View on controversial issues, Book Reviews, Correspondence, and Abstracts from affiliated neuroanesthesiology societies. JNA is the Official Journal of the Society for Neuroscience in Anesthesiology and Critical Care, the Neuroanaesthesia and Critical Care Society of Great Britain and Ireland, the Association de Neuro-Anesthésiologie Réanimation de langue Française, the Wissenschaftlicher Arbeitskreis Neuroanästhesie der Deutschen Gesellschaft fur Anästhesiologie und Intensivmedizen, the Arbeitsgemeinschaft Deutschsprachiger Neuroanästhesisten und Neuro-Intensivmediziner, the Korean Society of Neuroanesthesia, the Japanese Society of Neuroanesthesia and Critical Care, the Neuroanesthesiology Chapter of the Colegio Mexicano de Anesthesiología, the Indian Society of Neuroanesthesiology and Critical Care, and the Thai Society for Neuroanesthesia.
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