接受椎旁置管心血管手术的出血风险患者发生血肿的风险

Risk of Hematoma in Patients With a Bleeding Risk Undergoing Cardiovascular Surgery With a Paravertebral Catheter.

作者信息

Okitsu Kenta, Iritakenishi Takeshi, Iwasaki Mitsuo, Imada Tatsuyuki, Fujino Yuji

机构信息

Branch of Anaesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.

出版信息

J Cardiothorac Vasc Anesth. 2017 Apr;31(2):453-457. doi: 10.1053/j.jvca.2016.06.002. Epub 2016 Jun 3.

DOI:10.1053/j.jvca.2016.06.002

PMID:27576217

Abstract

OBJECTIVE

This study aimed to determine the risk of hematoma associated with thoracic paravertebral block (TPVB) in patients undergoing cardiovascular surgery.

DESIGN

Retrospective analysis.

SETTING

Single university hospital.

PARTICIPANTS

The study comprised 141 patients who underwent cardiovascular surgery with TPVB to relieve postoperative pain.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Three patients were excluded and of the remaining 138, TPVB was performed in 135, ages 11 to 96 years, who either had a clotting abnormality or were on anticoagulant or antiplatelet therapy. No paravertebral, epidural, or spinal hematoma was detected, and only 1 case of superficial bleeding was observed. The frequency of hematoma associated with TPVB in patients with a risk of bleeding undergoing cardiovascular surgery was calculated as 0% (95% confidence interval 0-2.7).

CONCLUSION

Hematoma did not occur in patients at risk of bleeding who underwent cardiovascular surgery with TPVB for postoperative pain management. However, the risk and benefit in each case still must be considered carefully to determine whether TPVB is indicated.

摘要