Manoli Arthur, Atchabahian Arthur, Davidovitch Roy I, Egol Kenneth A
Department of Orthopaedic Surgery NYU Hospital for Joint Diseases, New York, NY.
J Orthop Trauma. 2017 Mar;31(3):164-167. doi: 10.1097/BOT.0000000000000773.
To determine the effect of spinal anesthesia (SA) on short-term outcomes when compared with general anesthesia in operatively managed tibial plateau fractures.
This is an institutional review board-approved retrospective review of prospectively collected data.
Two level-1 trauma centers.
One hundred twelve patients with a surgically managed tibial plateau fracture were identified within a registry of patients.
Of these, 29 (25.9%) received SA and 83 (74.1%) received general anesthesia in a nonrandomized fashion.
Short Musculoskeletal Functional Assessment scores, pain levels, knee range of motion, complications, and reoperations.
SA was found to be a predictor of lower pain scores at 3 months (odds ratio, 0.32; 95% confidence interval, 0.12-0.95; P = 0.039) but not at 6 months (P = 0.266) or the latest follow-up (P = 0.056). In the multivariate Short Musculoskeletal Functional Assessment model, although anesthesia type was not found to be a statistically significant predictor, other predictors were identified. Anesthesia type was not a predictor of complications or reoperations. In the univariate analysis, SA was associated with an increased knee range of motion at 3 months (121 vs. 111 degrees; P = 0.048) but not at 6 months (P = 0.31) or the latest follow-up (P = 0.053).
In patients who undergo surgical management of a tibial plateau fracture, the use of SA is associated with decreased pain levels in the early postoperative period; however, there was no effect on functional assessment scores.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
与全身麻醉相比，确定脊髓麻醉（SA）对手术治疗胫骨平台骨折短期预后的影响。
这是一项经机构审查委员会批准的对前瞻性收集数据的回顾性研究。
两个一级创伤中心。
在患者登记册中识别出112例接受手术治疗的胫骨平台骨折患者。
其中，29例（25.9%）接受脊髓麻醉，83例（74.1%）以非随机方式接受全身麻醉。
简短肌肉骨骼功能评估评分、疼痛程度、膝关节活动范围、并发症及再次手术情况。
发现脊髓麻醉是术后3个月疼痛评分较低的一个预测因素（比值比，0.32；95%置信区间，0.12 - ˌ0.95；P = 0.039），但在6个月时并非如此（P = 0.266），在最新随访时也不是（P = 0.056）。在多变量简短肌肉骨骼功能评估模型中，虽然麻醉类型未被发现是具有统计学意义的预测因素，但识别出了其他预测因素。麻醉类型不是并发症或再次手术的预测因素。在单变量分析中，脊髓麻醉与术后3个月膝关节活动范围增加有关（121°对111°；P = 0.048），但在6个月时并非如此（P = 0.31），在最新随访时也不是（P = 0.053）。
在接受胫骨平台骨折手术治疗的患者中，使用脊髓麻醉与术后早期疼痛程度降低有关；然而，对功能评估评分没有影响。
治疗性三级证据。有关证据级别的完整描述，请参阅作者指南。
