患者教育和全膝关节置换术的麻醉选择。
Patient education and anesthesia choice for total knee arthroplasty.
机构信息
Department of Anesthesiology and Critical Care, University of Pennsylvania, USA.
Department of Orthopedic Surgery, University of Pennsylvania, USA.
出版信息
Patient Educ Couns. 2017 Sep;100(9):1709-1713. doi: 10.1016/j.pec.2017.04.014. Epub 2017 Apr 29.
OBJECTIVES
Spinal anesthesia (SA) for Total Knee Arthroplasty (TKA) may be associated with better patients' outcomes. This study aims to assess the association between preoperative education about the advantage of SA over general anesthesia (GA) for TKA and the likelihood of patient choice of NA.
METHODS
Patients undergoing unilateral primary TKA were identified. Type of anesthesia (GA or SA), attendance of the (joints class), patient demographics, ASA status, anticoagulation status, and diagnosis of back problems were recoded. Regression analysis was used to assess the association between the type of anesthesia and attendance of the joints class.
RESULTS
1010 patients were identified to have unilateral primary TKA. 31% of patients attended the joint class. Patients who attended the joints class were more likely to receive SA when compared to those who did not attend (OR=1.7, CI: 1.2-2.5, P=0.004) after adjusting for other variables.
CONCLUSION
Preoperative education about advantages of SA may be associated with an increase in patients receiving SA for TKA.
PRACTICE IMPLICATIONS
Increase in patients receiving SA for TKA may improve outcomes.
目的
全膝关节置换术（TKA）的椎管内麻醉（SA）可能与更好的患者结局相关。本研究旨在评估关于 SA 相对于全身麻醉（GA）用于 TKA 的优势的术前教育与患者选择区域阻滞麻醉（NA）的可能性之间的关联。
方法
确定了接受单侧初次 TKA 的患者。记录麻醉类型（GA 或 SA）、参加关节课程、患者人口统计学特征、ASA 状态、抗凝状态和背部问题的诊断。回归分析用于评估麻醉类型与关节课程参加之间的关联。
结果
确定了 1010 例接受单侧初次 TKA 的患者。31%的患者参加了关节课程。与未参加关节课程的患者相比，参加关节课程的患者更有可能接受 SA（OR=1.7，CI：1.2-2.5，P=0.004），调整其他变量后。
结论
关于 SA 优势的术前教育可能与接受 TKA 的 SA 患者增加有关。
实践意义
接受 TKA 的 SA 患者的增加可能会改善结果。
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