指神经阻滞对术中血红蛋白监测准确性的影响:一项随机临床试验

IF 0.1 Q4 ANESTHESIOLOGY
R. S. Moharari, B. M. Davani, P. Pourfakhr, R. Y. Nooraie, M. Khajavi, F. Etezadi, A. Najafi
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引用次数: 0

摘要

背景:由于输血的潜在并发症和成本,在手术期间向患者输血的决定至关重要。通过分光光度法测量血红蛋白水平(SpHb)在做出这一决定中起着重要作用。SpHb的准确性取决于手指的灌注。由于指神经阻滞(DNB)可以增强血液循环,我们旨在研究DNB对SpHb准确性的影响。方法:将接受脊柱手术的患者随机分为两组。A组左手接受DNB,B组右手接受DNB。在每组中,另一只手被视为对照。Rainbow成人ReSposable传感器连接在患者的双手上。在手术切口前和每1.5小时,记录双手的SpHb值和灌注指数。同时,抽取动脉血样并送往实验室进行血红蛋白浓度测量。这是评估血红蛋白水平(labHb)的金标准。我们使用混合效应广义线性模型来测试自变量对每个时间点SpHb和labHb之间差异的影响。结果:SpHb显示出比实验室评估的血红蛋白水平更高的血红蛋白水平。对于较低的labHb值,SpHb和labHb的差异更大。labHb降低一个单位,SpHb和labHb之间的差异增加了0.56 g dL-1,这在统计学上是显著的。DNB显著增加SpHb和labHb之间的差异0.42gdL-1。DNB对SpHb和labHb之间差异的影响在手术开始后三小时内是显著的(阻塞和未阻塞的手之间的差异为0.58 g dL-1)。结论:本研究表明,当血红蛋白水平较低时,分光光度法的准确性会降低。尽管DNB增加了手指灌注,但它会导致SpHb对血红蛋白水平的高估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of digital nerve block on the accuracy of hemoglobin monitoring during surgery: A randomized clinical trial
Background: The decision to transfuse blood products to patients during surgery is critical, due to the potential complications and costs of transfusion. Measuring hemoglobin level by spectrophotometry (SpHb) plays an important role in making this decision. The accuracy of SpHb depends on the finger perfusion. Since digital nerve blocks (DNB) can enhance blood circulation, we aimed at investigating DNB effects on the accuracy of SpHb. Methods: Patients undergoing spine surgery were randomly assigned to two groups. Group A received DNB in the left hand, and group B received DNB in the right hand. In each group, the other hand was considered as the control. Rainbow adult ReSposable sensors were attached to the patients’ both hands. Before surgical incision and every 1.5 hours, the SpHb values of both hands and the perfusion index were recorded. Concomitantly, arterial blood samples were drawn and sent to the lab for hemoglobin concentration measurement. This served as the gold standard for assessing hemoglobin levels (labHb). We used a mixed-effects generalized linear model to test the effect of independent variables on the difference between SpHb and labHb at each time point. Results: The SpHb displayed higher hemoglobin levels than those assessed by the lab. For lower labHb values, the SpHb-labHb differences were larger. A one-unit decrease in labHb increased the difference between SpHb and labHb by 0.56 g dL -1 , which was statistically significant. DNB significantly increased the difference between SpHb and labHb by 0.42 g dL -1 . The effect of DNB on the difference between SpHb and labHb was significant up to three hours after the beginning of surgery (0.58 g dL -1 difference between blocked and non-blocked hands). Conclusion: This study shows that, when hemoglobin levels are low, the accuracy of spectrophotometry decreases. Although DNB increases finger perfusion, it leads to an overestimation of hemoglobin levels by SpHb.
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来源期刊
CiteScore
0.20
自引率
0.00%
发文量
2
期刊介绍: L’Acta Anaesthesiologica Belgica est le journal de la SBAR, publié 4 fois par an. L’Acta a été publié pour la première fois en 1950. Depuis 1973 l’Acta est publié dans la langue Anglaise, ce qui a été résulté à un rayonnement plus internationaux. Depuis lors l’Acta est devenu un journal à ne pas manquer dans le domaine d’Anesthésie Belge, offrant e.a. les textes du congrès annuel, les Research Meetings, … Vous en trouvez aussi les dates des Research Meetings, du congrès annuel et des autres réunions.
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