脊柱麻醉对老年全髋关节置换术患者坐骨神经/腰丛神经联合阻滞的影响:一项回顾性研究。

IF 1.5 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Saudi Medicine Pub Date : 2022-05-01 Epub Date: 2022-06-02 DOI:10.5144/0256-4947.2022.174
Mustafa Kaçmaz, Zeynep Yuksel Turhan
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引用次数: 1

摘要

背景:老年患者长骨骨折死亡的最重要原因是股骨骨折需要全髋关节置换术(THA)。THA手术可能导致严重的术后疼痛、长时间住院、需要输血和死亡。目的:比较脊髓麻醉(SA)与坐骨神经/腰丛神经联合阻滞(CSLPB)的效果。设计:回顾性队列trıal。地点:土耳其大学医院。患者和方法:我们根据手术日期(最近一次)从电子病历中选择患者,并比较人口统计学和术前和术后临床特征,包括术后前48小时内阿片类药物的使用量、30天死亡率、住院时间、术中氧饱和度(SpO2)和平均动脉压(MAP)值、手术持续时间和输血需求。主要结局指标:术后48小时内阿片类药物使用情况。样本量:每组204,102例患者,总中位(IQR)年龄为82(10.2)岁。结果:两组在术后48小时内阿片类药物使用量、30天死亡率、重症监护需求、手术时间、输血需求和住院时间方面无显著差异。CSLPB组术中SpO2值较低(P= 0.03), SA组术中MAP值较低(P= 0.046)。CSLPB组术前美国麻醉学会评分(ASA)评分(P= 0.039)及共病数较高。结论:在老年THA手术中,我们更倾向于采用CSLPB配合标准化镇静方案进行麻醉。局限性:回顾性设计和单一中心。利益冲突:无。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Spinal anesthesia versus combined sciatic nerve/lumbar plexus nerve block in elderly patients undergoing total hip arthroplasty: a retrospective study.

Spinal anesthesia versus combined sciatic nerve/lumbar plexus nerve block in elderly patients undergoing total hip arthroplasty: a retrospective study.

Spinal anesthesia versus combined sciatic nerve/lumbar plexus nerve block in elderly patients undergoing total hip arthroplasty: a retrospective study.

Background: The most important cause of mortality due to long bone fractures in the elderly patients are femoral fractures that require total hip arthroplasty (THA). THA surgeries may cause severe postoperative pain, long hospital stays, a need for transfusion and mortality.

Objective: Compare outcomes of spinal anesthesia (SA) versus combined sciatic nerve/lumbar plexus block (CSLPB).

Design: Retrospective cohort trıal.

Setting: University hospital in Turkey.

Patients and methods: We selected patients from the electronic medical records by date of surgery (most recent first) and compared demographic and pre- and postoperative clinical characteristics including the amount of opioid use within the first 48 postoperative hours, 30-day mortality rates, length of hospital stay, intraoperative oxygen saturation (SpO2) and mean arterial pressure (MAP) values, duration of the surgery, and blood transfusion need.

Main outcome measure: Opioid use within the first 48 postoperative hours.

Sample size: 204, 102 patients in each group with overall median (IQR) age of 82 (10.2) years.

Results: There was no significant difference between the groups in terms of the amount of opioid use within the postoperative 48 hours, 30-day mortality rates, intensive care need, duration of the surgery, blood transfusion need, and length of hospital stay. While the intraoperative SpO2 value was lower in the CSLPB group (P=.03), MAP values were lower in the SA group (P=.046). Preoperative American Society of Anesthesiology score (ASA) scores (P=.039) and the number of comorbidities were higher in the CSLPB group.

Conclusion: We prefer CSLPB used with standardized sedation protocols for anesthesia in THA surgery in elderly patients.

Limitations: Retrospective design and single-centered.

Conflict of interest: None.

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来源期刊
Annals of Saudi Medicine
Annals of Saudi Medicine 医学-医学:内科
CiteScore
2.80
自引率
0.00%
发文量
44
审稿时长
4-8 weeks
期刊介绍: The Annals of Saudi Medicine (ASM) is published bimonthly by King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. We publish scientific reports of clinical interest in English. All submissions are subject to peer review by the editorial board and by reviewers in appropriate specialties. The journal will consider for publication manuscripts from any part of the world, but particularly reports that would be of interest to readers in the Middle East or other parts of Asia and Africa. Please go to the Author Resource Center for additional information.
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