前足手术清醒局部麻醉与全身麻醉的前瞻性比较。
A prospective comparison of wide-awake local anesthesia and general anesthesia for forefoot surgery.
作者信息
Wright John, MacNeill A Luke, Mayich D Joshua
机构信息
Dalhousie University, 100 Tucker Park Road, P.O. Box 5050, Saint John, NB E2L 4L5, Canada.
University of New Brunswick, 100 Tucker Park Road, P.O. Box 5050, Saint John, NB E2L 4L5, Canada.
出版信息
Foot Ankle Surg. 2019 Apr;25(2):211-214. doi: 10.1016/j.fas.2017.10.015. Epub 2017 Nov 6.
BACKGROUND
A recent case series suggested that surgery with wide-awake local anesthesia is tolerated well by most foot and ankle patients. However, patients were assessed retrospectively and there was no comparison group to show the relative efficacy of this approach. The present study was conducted to address these concerns.
METHODS
Perioperative pain and anxiety were assessed in 40 patients receiving forefoot surgery using either wide-awake local anesthesia or general anesthesia. Ratings were collected on the day of surgery using 11-point (0-10) numerical rating scales.
RESULTS
Patients in the two anesthesia groups reported no differences in preoperative pain (p=0.500) or anxiety (p=0.820). Patients who received wide-awake local anesthesia reported lower levels of postoperative pain (p<0.001) and anxiety (p<0.001) than patients who received general anesthesia. They also reported little pain (M=0.17, SD=0.32) or anxiety (M=1.33, SD=1.74) during the operation.
CONCLUSIONS
Results indicate that surgery with wide-awake local anesthesia is tolerated well by most patients, and that it may have some benefit compared to surgery with general anesthesia.
背景
近期的一系列病例表明，大多数足踝部患者对清醒状态下局部麻醉手术的耐受性良好。然而，对患者的评估是回顾性的，且没有对照组来显示这种方法的相对疗效。本研究旨在解决这些问题。
方法
对40例接受前足手术的患者进行围手术期疼痛和焦虑评估，这些患者分别采用清醒状态下局部麻醉或全身麻醉。在手术当天使用11分制（0 - 10）数字评分量表收集评分。
结果
两组麻醉患者术前疼痛（p = 0.500）或焦虑（p = 0.820）无差异。接受清醒状态下局部麻醉的患者术后疼痛（p < 0.001）和焦虑（p < 0.001）水平低于接受全身麻醉的患者。他们在手术过程中也几乎没有疼痛（M = 0.17，SD = 0.32）或焦虑（M = 1.33，SD = 1.74）。
结论
结果表明，大多数患者对清醒状态下局部麻醉手术的耐受性良好，与全身麻醉手术相比可能具有一些优势。
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