Sellbrandt Irene, Brattwall Metha, Warrén Stomberg Margareta, Jildenstål Pether, Jakobsson Jan G
Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Mölndal, Sweden.
The Sahlgrenska Academy Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
F1000Res. 2017 Nov 13;6:1996. doi: 10.12688/f1000research.13004.1. eCollection 2017.
Anaesthetic technique for open surgery of acute distal for arm fracture in adults/elderly is not well defined. Regional anaesthesia, general anaesthesia or a combined general and regional block may be considered. General anaesthetic technique, the timing and drug/drug combination for the regional block must also be considered. This is a study around published studies assessing anaesthtic technique for wrist surgery. A systematic database search was performed and papers describing the effect of anaesthetic techniques were included. We found sparse evidence for what anaesthetic technique is optimal for open wrist fracture repair. In total only six studies were found using our inclusion criteria, which all supported the short term, early recovery benefits of regional anaesthesia as part of multi-modal analgesia. More protracted outcomes and putting the type of block into context of quality of recovery and patients' satisfaction is lacking in the literature. The risk for a pain rebound when the block vanishes should also be acknowledged. Therefore, further high quality studies are warranted concerning the anaesthetic technique for this type of surgery.
成人/老年人急性前臂远端骨折开放手术的麻醉技术尚无明确界定。可考虑区域麻醉、全身麻醉或全身与区域联合阻滞。还必须考虑全身麻醉技术、区域阻滞的时机以及药物/药物组合。这是一项围绕已发表研究展开的关于评估腕部手术麻醉技术的研究。进行了系统的数据库检索，并纳入了描述麻醉技术效果的论文。我们发现几乎没有证据表明哪种麻醉技术最适合开放性腕部骨折修复。使用我们的纳入标准总共仅找到六项研究，所有这些研究均支持区域麻醉作为多模式镇痛一部分的短期、早期恢复益处。文献中缺乏更长期的结果以及将阻滞类型与恢复质量和患者满意度相结合的内容。还应认识到阻滞消失时疼痛反弹的风险。因此，有必要针对此类手术的麻醉技术开展进一步的高质量研究。
