{"title":"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。","authors":"Mustafa Kaçmaz, Zeynep Yuksel Turhan","doi":"10.5144/0256-4947.2022.174","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>Compare outcomes of spinal anesthesia (SA) versus combined sciatic nerve/lumbar plexus block (CSLPB).</p><p><strong>Design: </strong>Retrospective cohort trıal.</p><p><strong>Setting: </strong>University hospital in Turkey.</p><p><strong>Patients and methods: </strong>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 (SpO<sub>2</sub>) and mean arterial pressure (MAP) values, duration of the surgery, and blood transfusion need.</p><p><strong>Main outcome measure: </strong>Opioid use within the first 48 postoperative hours.</p><p><strong>Sample size: </strong>204, 102 patients in each group with overall median (IQR) age of 82 (10.2) years.</p><p><strong>Results: </strong>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 SpO<sub>2</sub> value was lower in the CSLPB group (<i>P</i>=.03), MAP values were lower in the SA group (<i>P</i>=.046). Preoperative American Society of Anesthesiology score (ASA) scores (<i>P</i>=.039) and the number of comorbidities were higher in the CSLPB group.</p><p><strong>Conclusion: </strong>We prefer CSLPB used with standardized sedation protocols for anesthesia in THA surgery in elderly patients.</p><p><strong>Limitations: </strong>Retrospective design and single-centered.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"174-180"},"PeriodicalIF":16.4000,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c8/7c/0256-4947.2022.174.PMC9167455.pdf","citationCount":"1","resultStr":"{\"title\":\"Spinal anesthesia versus combined sciatic nerve/lumbar plexus nerve block in elderly patients undergoing total hip arthroplasty: a retrospective study.\",\"authors\":\"Mustafa Kaçmaz, Zeynep Yuksel Turhan\",\"doi\":\"10.5144/0256-4947.2022.174\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>Compare outcomes of spinal anesthesia (SA) versus combined sciatic nerve/lumbar plexus block (CSLPB).</p><p><strong>Design: </strong>Retrospective cohort trıal.</p><p><strong>Setting: </strong>University hospital in Turkey.</p><p><strong>Patients and methods: </strong>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 (SpO<sub>2</sub>) and mean arterial pressure (MAP) values, duration of the surgery, and blood transfusion need.</p><p><strong>Main outcome measure: </strong>Opioid use within the first 48 postoperative hours.</p><p><strong>Sample size: </strong>204, 102 patients in each group with overall median (IQR) age of 82 (10.2) years.</p><p><strong>Results: </strong>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 SpO<sub>2</sub> value was lower in the CSLPB group (<i>P</i>=.03), MAP values were lower in the SA group (<i>P</i>=.046). Preoperative American Society of Anesthesiology score (ASA) scores (<i>P</i>=.039) and the number of comorbidities were higher in the CSLPB group.</p><p><strong>Conclusion: </strong>We prefer CSLPB used with standardized sedation protocols for anesthesia in THA surgery in elderly patients.</p><p><strong>Limitations: </strong>Retrospective design and single-centered.</p><p><strong>Conflict of interest: </strong>None.</p>\",\"PeriodicalId\":1,\"journal\":{\"name\":\"Accounts of Chemical Research\",\"volume\":\" \",\"pages\":\"174-180\"},\"PeriodicalIF\":16.4000,\"publicationDate\":\"2022-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c8/7c/0256-4947.2022.174.PMC9167455.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Accounts of Chemical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5144/0256-4947.2022.174\",\"RegionNum\":1,\"RegionCategory\":\"化学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/6/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5144/0256-4947.2022.174","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/6/2 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
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.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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