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静脉镇静下的胫骨取骨术:发病率与患者体验

Tibial bone harvesting under intravenous sedation: Morbidity and patient experiences.

作者信息

Marchena Jose M, Block Michael S, Stover John D

机构信息

Department of Oral and Maxillofacial Surgery, Louisiana State University School of Dentistry, New Orleans 70119, USA.

出版信息

J Oral Maxillofac Surg. 2002 Oct;60(10):1151-4. doi: 10.1053/joms.2002.34990.

Abstract

PURPOSE

The aims of this study were to evaluate the complication rate, the recovery, and the experience in patients undergoing tibial bone harvesting under intravenous sedation.

PATIENTS AND METHODS

This was a prospective study of 10 consecutive patients who underwent unilateral or bilateral sinus grafting with tibial bone grafts under intravenous sedation in a 3-month period in the oral and maxillofacial surgery outpatient clinic. All medications used perioperatively were recorded. Postoperative analgesic requirements were evaluated, along with patient recovery and complications and the patients' subjective experiences.

RESULTS

All patients underwent unilateral tibial bone harvesting using a nontrephination technique under sedation with meperidine and methohexital. On average, 11.3 mL of compressed marrow was harvested. All patients described a sensation of scraping intraoperatively but not of severe pain. On average, patients required narcotic analgesics for 1.2 days postoperatively and non-narcotic analgesics for 10.2 days. Discomfort and a gait disturbance were present for an average of 9 to 10 days. There were no wound complications, and all patients were satisfied with the recovery and donor site.

CONCLUSIONS

Tibial bone harvesting under intravenous anesthesia in an office setting is well tolerated and well accepted. The postoperative recovery and complication rate also seem to compare favorably with those of tibial grafting under general anesthesia.

摘要

目的

本研究旨在评估在静脉镇静下进行胫骨取骨患者的并发症发生率、恢复情况及体验。

患者与方法

这是一项前瞻性研究,连续纳入10例患者,他们在口腔颌面外科门诊3个月内于静脉镇静下接受了单侧或双侧胫骨骨移植的鼻窦植骨术。记录围手术期使用的所有药物。评估术后镇痛需求、患者恢复情况、并发症以及患者的主观体验。

结果

所有患者在哌替啶和甲己炔巴比妥镇静下采用非环钻技术进行单侧胫骨取骨。平均采集到11.3 mL浓缩骨髓。所有患者术中均描述有刮擦感,但无剧痛。患者术后平均需要1.2天的麻醉性镇痛药和10.2天的非麻醉性镇痛药。不适和步态障碍平均持续9至10天。无伤口并发症,所有患者对恢复情况和供骨部位均满意。

结论

在门诊环境下静脉麻醉下行胫骨取骨耐受性良好且易于接受。术后恢复情况和并发症发生率似乎也优于全身麻醉下的胫骨植骨。

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