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发展中国家顶尖创伤中心的骨盆-髋臼骨折手术的围手术期结局受麻醉影响:一项回顾性分析。

Effect of anaesthesia on the perioperative outcomes of pelvi-acetabular fracture surgeries in the apex trauma centre of a developing country-a retrospective analysis.

机构信息

Department of Anaesthesia, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.

Department of Anaesthesia, Pain and Palliative Medicine, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Burns Trauma. 2015 Jul 31;3:10. doi: 10.1186/s41038-015-0011-y. eCollection 2015.

DOI:10.1186/s41038-015-0011-y
PMID:27574656
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4963930/
Abstract

BACKGROUND

Regional anaesthesia has been proposed to reduce intraoperative blood loss, duration of hospital stay and in-hospital complications with improved postoperative pain control. General anaesthesia is advantageous for prolonged surgeries. We hypothesized that combined regional and general anaesthesia would offer advantages of both in pelvi-acetabular fracture surgeries.

METHODS

We identified 71 patients who underwent open reduction and internal fixation of pelvi-acetabular fractures from May 2012 to 2013 in our trauma centre. We excluded patients with incomplete records (n = 4) and other injuries operated along (n = 8). Hence, 59 patients were divided into three groups: G group (general anaesthesia), R group (regional anaesthesia) and GR group (combined regional and general anaesthesia). Main outcome measurements studied were intraoperative blood loss, duration of hospital stay, duration of surgery and intraoperative and postoperative complications.

RESULTS

No differences were obtained in between the groups in terms of age, gender, Injury Severity Score, number of comorbidities, or duration from injury to surgery. No significant differences were found between the three groups for intraoperative blood loss, days of hospital stay and duration of surgery. Intraoperative and postoperative complications were also comparable between the groups (p > 0.05).

CONCLUSIONS

There is no specific significant advantage of the technique of anaesthesia on the observed perioperative complications in pelvi-acetabular fracture surgeries.

摘要

背景

区域麻醉被认为可以减少术中失血量、住院时间和院内并发症,并改善术后疼痛控制。全身麻醉有利于延长手术时间。我们假设联合区域和全身麻醉在骨盆-髋臼骨折手术中会兼具两者的优势。

方法

我们在创伤中心确定了 71 名接受骨盆-髋臼骨折切开复位内固定术的患者。我们排除了记录不完整的患者(n=4)和同时进行其他损伤手术的患者(n=8)。因此,59 名患者被分为三组:G 组(全身麻醉)、R 组(区域麻醉)和 GR 组(联合区域和全身麻醉)。主要观察指标为术中失血量、住院时间、手术时间以及术中、术后并发症。

结果

各组间在年龄、性别、损伤严重程度评分、合并症数量或从损伤到手术的时间方面无差异。三组间术中失血量、住院天数和手术时间无显著差异。术中、术后并发症也无差异(p>0.05)。

结论

在骨盆-髋臼骨折手术中,麻醉技术对观察到的围手术期并发症没有特定的显著优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b016/4963930/ae1ce03830e7/41038_2015_11_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b016/4963930/ae1ce03830e7/41038_2015_11_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b016/4963930/ae1ce03830e7/41038_2015_11_Fig1_HTML.jpg

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The Jones-Powell Classification of open pelvic fractures: a multicenter study evaluating mortality rates.琼斯-鲍威尔开放性骨盆骨折分类:一项评估死亡率的多中心研究。
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Spinal anesthesia versus general anesthesia for elective lumbar spine surgery: A randomized clinical trial.择期腰椎手术中脊髓麻醉与全身麻醉的比较:一项随机临床试验。
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