低剂量甲哌卡因脊柱麻醉与全身麻醉的膝关节镜手术术后恢复时间:回顾性倾向评分匹配队列研究

Q3 Medicine
Cheng Lin, Grace Xu, Rohan Dadak, Hesham Youssef, Kamal Kumar
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引用次数: 0

摘要

全身麻醉(GA)是门诊手术的首选技术,因为全身麻醉与可预测的恢复时间有关。然而,与脊髓麻醉(SA)相比,它有更高的术后恶心、呕吐和嗜睡的风险。本研究旨在确定30 mg SA的甲哌卡因的恢复时间是否优于GA。我们的单中心回顾性研究采用多变量logistic回归模型,将麻醉方式作为年龄、性别、体重指数和美国麻醉医师协会身体状况的函数,为每位患者生成倾向评分,以进行匹配。筛选455例患者后,每组匹配111例患者。SA与23.0分钟相关(95% CI, -∞至31.0;P < 0.0001)较长的恢复时间,较短的手术室时间(-8.0分钟,95% CI -13.0至-3.0),更有可能绕过第一阶段恢复(OR, 2.77;95% CI, 1.20 - 6.88)和较少的阿片类药物使用(-0.5 mg;95% CI, -3.7至-0.0001),但住院时间(LOS)无差异。脊髓麻醉与较短的恢复时间相关。相关的1期旁路和类似的LOS表明SA是GA的可行替代方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Postoperative Recovery Time After Knee Arthroscopic Surgery Using Low Dose Mepivacaine Spinal Anesthesia Versus General Anesthesia: A Retrospective Propensity Score Matched Cohort Study.

General anesthesia (GA) is the preferred technique in ambulatory surgery because GA is associated with a predictable recovery time. However, it carries higher risk of postoperative nausea and vomiting and drowsiness when compared with spinal anesthesia (SA). This study aimed to determine whether the recovery time in mepivacaine of 30 mg SA is noninferior when compared with GA. Our single-center retrospective study used a multivariable logistic regression to model anesthetic modality as a function of age, sex, body mass index, and American Society of Anesthesiologists physical status to generate a propensity score for each patient for matching. After screening 455 patients, 111 patients in each group were matched. SA was associated with 23.0 minutes (95% CI, -∞ to 31.0; P < .0001) longer recovery time, shorter operating room time (-8.0 minutes, 95% CI -13.0 to -3.0), more likely to bypass phase 1 recovery (OR, 2.77; 95% CI, 1.20 to 6.88) and less opioid use (-0.5 mg; 95% CI, -3.7 to -0.0001) but no difference in length of stay (LOS). Spinal anesthesia was correlated with inferior recovery time. The associated phase 1 bypass and similar LOS suggest SA as a viable alternative to GA.

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来源期刊
AANA journal
AANA journal Medicine-Medicine (all)
CiteScore
1.20
自引率
0.00%
发文量
60
期刊介绍: Founded in 1931 and located in Park Ridge, Ill., the AANA is the professional organization for more than 90 percent of the nation’s nurse anesthetists. As advanced practice nurses, CRNAs administer approximately 32 million anesthetics in the United States each year. CRNAs practice in every setting where anesthesia is available and are the sole anesthesia providers in more than two-thirds of all rural hospitals. They administer every type of anesthetic, and provide care for every type of surgery or procedure, from open heart to cataract to pain management.
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