髋部骨折老年骨科麻醉中的周围神经阻滞:揭示经济和临床层面

Emery Niyonkuru, Xu Zhang, Peng Ma
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引用次数: 0

摘要

老年髋部骨折患者的健康和医疗成本负担沉重。有效的疼痛管理对最佳康复至关重要,这促使人们探索外周神经阻滞(PNBs)等创新策略。本综述调查了外周神经阻滞对接受髋部骨折手术的老年患者的临床和经济影响。该系统性综述通过搜索 PubMed、Cochrane 等数据库中 2023 年 9 月之前发表的研究,确定了在该人群中使用 PNB 的相关研究。研究结果显示了使用 PNBs 的几种潜在益处,包括有针对性的疼痛控制、降低阿片类药物依赖性以及促进尽早康复。值得注意的是,分析强调了双重影响,PNBs 在降低成本的同时,还具有缩短住院时间和减少并发症等潜在临床优势。不过,有关其对医疗成本影响的证据仍不确定。尽管成本效益存在不确定性,但总体趋势表明,PNBs 可带来积极的临床效果,包括改善康复和减少对阿片类药物的依赖。总之,PNBs 有望改善临床疗效并降低医疗资源使用率。为巩固成本效益,未来的研究应明确经济效益并完善 PNBs 的使用。关键词:髋部骨折、周围神经阻滞、老年人、住院时间、医疗费用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PERIPHERAL NERVE BLOCKS IN GERIATRIC ORTHOPEDIC ANESTHESIA FOR HIP FRACTURES: UNVEILING ECONOMIC AND CLINICAL DIMENSIONS
Hip fractures in elderly patients significantly burden health and healthcare costs. Effective pain management is crucial for optimal recovery, prompting the exploration of innovative strategies like peripheral nerve blocks (PNBs). This review investigated the clinical and economic impact of PNBs on geriatric patients undergoing hip fracture surgery. A systematic review identified relevant research on PNB use in this population, searching databases like PubMed, Cochrane, and others for studies published before September 2023. The findings revealed several potential benefits associated with PNBs, including targeted pain control, decreased opioid dependence, and facilitated earlier mobilization. Notably, the analysis highlighted a dual impact, with PNBs demonstrating potential clinical advantages like shorter hospital stays and fewer complications alongside their costs. However, the evidence of their influence on healthcare costs remains inconclusive. Despite the uncertainty surrounding cost-effectiveness, the overall trend suggests positive clinical outcomes associated with PNBs, including improved recovery and reduced opioid reliance. These potential benefits could translate to a positive impact on healthcare resource utilization. In conclusion, PNBs show promise for improved clinical outcomes and potentially reducing healthcare resource utilization. To solidify cost-effectiveness, future studies should pinpoint economic benefits and refine PNBs use. A more thorough analysis is needed to confirm these financial advantages. KEYWORDS: hip fracture, peripheral nerve blocks, elderly, hospitalization duration, healthcare costs.
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