氯普鲁卡因与甲哌卡因用于当日出院TKA脊髓麻醉的回顾性比较。

IF 4.4 Q2 Medicine
Noah Gilreath, Jonathan Liu, Cameron Thomson, Mohammad Daher, Sandi Caus, Harrison Dunn, Valentin Antoci, Thomas Barrett, Eric Cohen
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引用次数: 0

摘要

氯普鲁卡因是一种快速、短效的脊髓麻醉剂,可促进全膝关节置换术(TKA)术后更快恢复。然而,关于其在当日出院(SDD) TKA患者中的应用,文献有限。本研究比较氯普鲁卡因与甲哌卡因的临床疗效和安全性。方法:回顾性研究了2022年3月至2023年6月在单一门诊手术中心接受原发性TKA的178例患者,比较了氯普鲁卡因(n = 114)和甲哌卡因(n = 64)脊柱麻醉。评估手术结果,包括估计失血量(EBL)、手术时间、出院时间、90天急诊科就诊和90天再入院。此外,还记录了麻醉相关并发症,如低血压、心动过缓、尿潴留和麻醉后护理单位(PACU)结果。氯普鲁卡因组和甲哌卡因组之间的连续变量通过独立样本t检验进行比较,而分类变量通过卡方检验进行分析。p值小于0.05被认为具有统计学意义。结果:两组患者的基线特征无差异。氯普鲁卡因组手术时间明显缩短(73.1分钟vs 84.9分钟)。结论:与甲哌卡因相比,氯普鲁卡因脊髓麻醉治疗SDD TKA的尿潴留率更低,导尿需求减少,PACU神经系统疾病较少,出院时间更快。两组之间的手术结果没有差异,也没有计划外直接入院的情况。这些结果表明氯普鲁卡因可以安全可靠地替代甲哌卡因用于门诊TKA。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Retrospective comparison of chloroprocaine and mepivacaine in spinal anesthesia for same-day discharge TKA.

Introduction: Chloroprocaine is a rapid, short-acting spinal anesthetic that may facilitate quicker postoperative recovery in total knee arthroplasty (TKA). However, limited literature exists regarding its use in patients undergoing same-day discharge (SDD) TKA. This study evaluated the clinical outcomes and safety of chloroprocaine compared with those of mepivacaine.

Methods: This retrospective study of 178 patients who underwent primary TKA at a single ambulatory surgery center from March 2022 to June 2023 compared chloroprocaine (n = 114) and mepivacaine (n = 64) spinal anesthesia. Surgical outcomes, including estimated blood loss (EBL), operative time, discharge time, 90-day emergency department visits, and 90-day readmissions, were evaluated. In addition, anesthesia-related complications such as hypotension, bradycardia, urinary retention, and postanesthesia care unit (PACU) outcomes were recorded. Continuous variables between the chloroprocaine and mepivacaine groups were compared via independent sample t-tests, whereas categorical variables were analyzed via chi-squared tests. A p-value of less than 0.05 was considered statistically significant.

Results: There were no differences in the baseline characteristics between the two groups. The chloroprocaine group had a significantly shorter operative time (73.1 versus 84.9 min, p < 0.001) and faster discharge (3.7 versus 4.2 h, p < 0.001), with no difference in EBL. Patients in the chloroprocaine group had a lower incidence of urinary retention (2.5 versus 15.6%, p = 0.004), a lower proportion of patients who needed a urinary catheter (2.6 versus 14.1%, p = 0.004), and fewer postoperative complaints of numbness (19.3 versus 39.1%, p = 0.004). There were no differences in surgical complications.

Conclusions: Compared with mepivacaine, chloroprocaine spinal anesthesia for SDD TKA was associated with lower rates of urinary retention, a reduced need for urinary catheterization, fewer neurological complaints in the PACU, and faster discharge times. No differences were observed in surgical outcomes between the groups, and there were no instances of unplanned direct admissions. These results suggest that chloroprocaine can be safely used as a reliable alternative to mepivacaine in outpatient TKA.

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来源期刊
CiteScore
6.50
自引率
0.00%
发文量
42
审稿时长
19 weeks
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