Wong Patrick B Y, McVicar Jason, Nelligan Kathleen, Bleackley Joanne C, McCartney Colin J L
Department of Anesthesiology, University of Ottawa, Ottawa, ON, Canada.
The Ottawa Hospital, General Campus, CCW 1401, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
Pain Manag. 2016;6(3):297-311. doi: 10.2217/pmt.16.6. Epub 2016 Mar 17.
Despite evidence in the literature, continuing wide variation exists in anesthetic technique for primary joint arthroplasties. Recent evidence suggests that neuraxial anesthesia has advantages over general anesthesia in terms of mortality, major morbidity and healthcare utilization. Yet, despite the proposed benefits, utilization of these two techniques varies greatly across geographical locations, with general anesthesia being most common for total hip arthroplasty (THA) and total knee arthroplasty (TKA) in parts of the world. We uncover some factors that promote or hinder the use of neuraxial anesthesia in THA and TKA. Healthcare professionals should be familiarized with the evidence for neuraxial anesthesia, and unbiased educational material should be developed for patients regarding anesthetic options for THA and TKA in order to promote best practice.
尽管文献中有相关证据，但初次关节置换术的麻醉技术仍存在广泛差异。最近的证据表明，在死亡率、主要并发症和医疗资源利用方面，神经轴索麻醉优于全身麻醉。然而，尽管有这些潜在益处，但这两种技术的使用在不同地理位置差异很大，在世界某些地区，全身麻醉是全髋关节置换术（THA）和全膝关节置换术（TKA）最常用的麻醉方式。我们发现了一些促进或阻碍在THA和TKA中使用神经轴索麻醉的因素。医疗保健专业人员应熟悉神经轴索麻醉的证据，并且应为患者开发关于THA和TKA麻醉选择的无偏见教育材料，以促进最佳实践。
