Gilbert T B, Hawkes W G, Hebel J R, Hudson J I, Kenzora J E, Zimmerman S I, Felsenthal G, Magaziner J
Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, USA.
Am J Orthop (Belle Mead NJ). 2000 Jan;29(1):25-35.
The Baltimore Hip Studies, a multicenter, noninterventional, observational trial, provided an opportunity to investigate the effects of anesthetic technique on the long-term outcome of elderly patients after hip fracture repair. Detailed interviews assessing functional status and pain were conducted during the hospital stay. Out-of-hospital evaluations were repeated after the procedure at 2, 6, 12, 18, and 24 months with a portable gait and balance laboratory. Multivariate analysis was done to determine the effects of anesthetic technique on functional and other outcomes, after controlling for multiple baseline variables. Of 741 enrolled patients who completed the study, 430 and 311 patients received spinal anesthesia or general anesthesia, respectively. Subgroup analysis of three spinal anesthetics, tetracaine, lidocaine, and epinephrine, was also done. In the present large observational study, general anesthesia was at least as efficacious as spinal anesthesia, and possibly better, in affording good long-term outcome.
巴尔的摩髋部研究是一项多中心、非干预性观察性试验，为研究麻醉技术对老年髋部骨折修复患者长期预后的影响提供了契机。在住院期间进行了详细访谈，评估功能状态和疼痛情况。术后2个月、6个月、12个月、18个月和24个月，使用便携式步态和平衡实验室进行院外评估。在控制多个基线变量后，进行多变量分析以确定麻醉技术对功能及其他预后的影响。在741名完成研究的入组患者中，分别有430例和311例接受了脊髓麻醉或全身麻醉。还对丁卡因、利多卡因和肾上腺素三种脊髓麻醉剂进行了亚组分析。在这项大型观察性研究中，全身麻醉在提供良好长期预后方面至少与脊髓麻醉一样有效，甚至可能更好。
