心脏手术中的硬膜外导管置入术：2012年风险评估
Epidural catheterization in cardiac surgery: the 2012 risk assessment.
作者信息
Hemmerling Thomas M, Cyr Shantale, Terrasini Nora
机构信息
Department of Anesthesiology, McGill University, Montreal, Canada and University of Pisa, Pisa, Italy.
出版信息
Ann Card Anaesth. 2013 Jul-Sep;16(3):169-77. doi: 10.4103/0971-9784.114237.
AIMS AND OBJECTIVES
The risk assessment of epidural hematoma due to catheter placement in patients undergoing cardiac surgery is essential since its benefits have to be weighed against risks, such as the risk of paraplegia. We determined the risk of the catheter-related epidural hematoma in cardiac surgery based on the cases reported in the literature up to September 2012.
MATERIALS AND METHODS
We included all reported cases of epidural catheter placement for cardiac surgery in web and in literature from 1966 to September 2012. Risks of other medical and non-medical activities were retrieved from recent reviews or national statistical reports.
RESULTS
Based on our analysis the risk of catheter-related epidural hematoma is 1 in 5493 with a 95% confidence interval (CI) of 1/970-1/31114. The risk of catheter-related epidural hematoma in cardiac surgery is similar to the risk in the general surgery population at 1 in 6,628 (95% CI 1/1,170-1/37,552).
CONCLUSIONS
The present risk calculation does not justify not offering epidural analgesia as part of a multimodal analgesia protocol in cardiac surgery.
目的
对于接受心脏手术的患者，评估置管导致硬膜外血肿的风险至关重要，因为必须权衡其益处与诸如截瘫风险等风险。我们根据截至2012年9月的文献报道病例，确定了心脏手术中与导管相关的硬膜外血肿风险。
材料与方法
我们纳入了1966年至2012年9月期间网络及文献中所有报道的心脏手术硬膜外置管病例。其他医疗及非医疗活动的风险则从近期综述或国家统计报告中获取。
结果
根据我们的分析，与导管相关的硬膜外血肿风险为1/5493，95%置信区间（CI）为1/970 - 1/31114。心脏手术中与导管相关的硬膜外血肿风险与普通外科人群相似，为1/6628（95% CI 1/1170 - 1/37552）。
结论
目前的风险计算结果表明，在心脏手术多模式镇痛方案中不提供硬膜外镇痛并无依据。
Zotero 插件