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髋关节置换手术麻醉技术的回顾性评估

Retrospective Evaluation of Anaesthesia Techniques for Hip Replacement Operations.

作者信息

Koç Murat, Saçan Özlem, Gamlı Mehmet, Taşpınar Vildan, Postacı Aysun, Fikir Emel, Dikmen Bayazit

机构信息

Clinic of Anaesthesia and Reanimation, Karabük State Hospital, Karabük, Turkey.

Clinic of Anaesthesia and Reanimation, Ankara Numune Training and Research Hospital, Ankara, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2014 Jun;42(3):133-9. doi: 10.5152/TJAR.2014.07108. Epub 2014 Jun 1.

Abstract

OBJECTIVE

In this retrospective study, we evaluated the demographic characteristics of patients that underwent hip replacement surgery in our orthopedic clinic. Associated diseases, preoperative laboratory findings, intraoperative findings, and the effect of admission or refusal to the intensive care unit on postoperative mortality and morbidity were recorded. Furthermore, we tried to identify surgical and anaesthetic methods applied, intraoperative hemodynamic changes, length of stay in the post-anaesthesia care unit, and postoperative complications.

METHODS

Demographic characteristics, co-morbidities, preoperative laboratory findings, intraoperative findings, and admission or refusal to the intensive care unit of patients who underwent hip replacement surgery between January 2008-December 2010 were enrolled.

RESULTS

Out of 500 patients, 33.4% (n=164) were operated under general anaesthesia, 34% (n=170) under combined spinal-epidural anaesthesia, 22.2% (n=111) under spinal anaesthesia, 6.4% (n=32) under combined lomber plexus block and sciatic nerve block, and 4% (n=20) under epidural anaesthesia. Mean hospital stay was 7 days in the general anaesthesia group and 5 days in the regional anaesthesia group.

CONCLUSION

American Society of Anesthesiologists (ASA) scores and incidence of co-morbidities were higher in the partial hip replacement group. Admission to the intensive care unit was lower in the total hip replacement group. Hospital stay was shorter in the partial hip replacement group. Mortality rates on the 7(th) and 30(th) days were higher in the partial hip replacement group.

摘要

目的

在这项回顾性研究中,我们评估了在我们骨科诊所接受髋关节置换手术患者的人口统计学特征。记录了相关疾病、术前实验室检查结果、术中发现,以及入住或拒绝入住重症监护病房对术后死亡率和发病率的影响。此外,我们试图确定所应用的手术和麻醉方法、术中血流动力学变化、麻醉后护理单元的住院时间以及术后并发症。

方法

纳入2008年1月至2010年12月期间接受髋关节置换手术患者的人口统计学特征、合并症、术前实验室检查结果、术中发现以及入住或拒绝入住重症监护病房的情况。

结果

500例患者中,33.4%(n = 164)在全身麻醉下进行手术,34%(n = 170)在腰麻 - 硬膜外联合麻醉下进行手术,22.2%(n = 111)在脊髓麻醉下进行手术,6.4%(n = 32)在腰丛阻滞联合坐骨神经阻滞下进行手术,4%(n = 20)在硬膜外麻醉下进行手术。全身麻醉组的平均住院时间为7天,区域麻醉组为5天。

结论

部分髋关节置换组的美国麻醉医师协会(ASA)评分和合并症发生率较高。全髋关节置换组入住重症监护病房的比例较低。部分髋关节置换组的住院时间较短。部分髋关节置换组在第7天和第30天的死亡率较高。

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