Application of enhanced recovery after surgery protocol in elderly patients receiving cardiac valve surgery

国际麻醉学与复苏杂志 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.1673-4378.2020.03.008

Man Li, Yanan Cao, Sisi Dai, G. Qin, Junjie Zhang, E. Wang

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Abstract

Objective To investigate the safety and efficacy of enhanced recovery after surgery (ERAS) protocol in elderly patients receiving cardiac valve surgery under cardiopulmonary bypass (CPB). Methods Elderly inpatients who were scheduled for valve plasty or replacement under CPB due to cardiac valve diseases were prospectively enrolled. According to the random number table method, they were divided into an ERAS group (n=22) and a control group (n=28). Patients in the ERAS group received ERAS protocol for perioperative management, while those in the control group received routine perioperative treatment. Both groups were com-pared for the length of hospitalization stay, the length of intensive care unit (ICU) stay, the indwelling time of tracheal catheters after surgery, the dosage of sufentanil, the recovery time, the consumption of red blood cell suspension after surgery, post-operative hemato-globin (Hb), the first defecation time after surgery, the time of postoperative use of vasoactive agents, the extubation time of drainage tubes after surgery, the Visual Analogue Scale (VAS) scores after surgery, hospitalization expense and postoperative adverse reactions. Results Compared with the control group, the ERAS group showed decreases in the length of hospitalization stay, the length of ICU stay, the indwelling time of tracheal catheters after surgery, the recovery time, the first defecation time after surgery, the time of postoperative use of vasoactive agents, and the extubation time of drainage tubes after surgery, where statistical differences were found as to the length of ICU stay, the indwelling time of tracheal catheters after surgery, the recovery time, the first defecation time after surgery, and the extubation time of drainage tubes after surgery between the two groups (P 0.05). Conclusions ERAS protocol is safe and effective for elderly patients receiving cardiac valve surgery under CPB. Key words: Valvular heart disease; Enhanced recovery after surgery; Postoperative recovery; Aged

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增强术后恢复方案在老年心脏瓣膜手术中的应用

目的探讨ERAS (enhanced recovery after surgery)方案在老年体外循环(CPB)下心脏瓣膜手术中的安全性和有效性。方法前瞻性纳入因心脏瓣膜疾病行CPB下瓣膜成形术或置换术的老年住院患者。根据随机数字表法将患者分为ERAS组(n=22)和对照组(n=28)。ERAS组患者接受ERAS方案围手术期管理，对照组患者接受常规围手术期治疗。比较两组患者的住院时间、重症监护病房(ICU)住院时间、术后气管导管留置时间、舒芬太尼用量、恢复时间、术后红细胞悬浮液消耗、术后血红蛋白(Hb)、术后首次排便时间、术后血管活性药物使用时间、术后拔管时间。术后视觉模拟评分(VAS)、住院费用及术后不良反应。结果ERAS组患者住院时间、ICU住院时间、术后气管导管留置时间、术后恢复时间、术后首次排便时间、术后血管活性药物使用时间、术后引流管拔管时间均较对照组减少，其中ICU住院时间、术后气管导管留置时间、术后气管导管留置时间、两组患者术后恢复时间、术后首次排便时间、术后拔管时间比较，差异有统计学意义(P < 0.05)。结论ERAS治疗老年CPB下心脏瓣膜手术安全有效。关键词:瓣膜性心脏病;增强术后恢复;术后恢复;岁的

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国际麻醉学与复苏杂志

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