Wolf Brian D, Munnangi Swapna, Pesso Raymond, McCahery Charles, Oad Madhu
Resident of the Department of Oral and Maxillofacial Surgery, Nassau University Medical Center, East Meadow, New York, USA.
Division of Trauma, Department of Surgery, Nassau University Medical Center, East Meadow, New York, USA.
Anesthesiol Res Pract. 2020 Mar 1;2020:2157295. doi: 10.1155/2020/2157295. eCollection 2020.
The purpose of this study was to correlate intraoperative anesthetic complications of trauma patients with their respective urine toxicology results.
This retrospective, single-center cohort study at a Level 1 trauma center included patients with the following criteria: (1) trauma admission between January 1, 2010, and December 31, 2016, (2) required surgical intervention, (3) are age 18 and older, and (4) urine toxicology screening was completed. Anesthetic records were evaluated for intraoperative complications.
The final analysis included 847 patients. The mean anesthesia time, American Society of Anesthesiologists physical status classification scores, change in body temperature, anesthetic complication rate, and mortality were not significantly different between urine toxicology positive and negative patients. Of note, a significantly lower proportion of the urine toxicology positive patients were extubated postoperatively in comparison to urine toxicology negative patients (57.32% vs 63.83%).
Trauma patients who presented with a positive urine toxicology screening are not at an increased risk for intraoperative anesthetic complications compared to those with a negative urine toxicology screening. However, our results indicated that the need for postoperative mechanical ventilation increased in the acutely intoxicated trauma patients when compared to those without preinjury intoxication.
本研究的目的是将创伤患者的术中麻醉并发症与其各自的尿液毒理学结果相关联。
这项在一级创伤中心进行的回顾性单中心队列研究纳入了符合以下标准的患者:(1)2010年1月1日至2016年12月31日期间因创伤入院,(2)需要手术干预,(3)年龄在18岁及以上,(4)完成了尿液毒理学筛查。对麻醉记录进行术中并发症评估。
最终分析纳入了847例患者。尿液毒理学阳性和阴性患者之间的平均麻醉时间、美国麻醉医师协会身体状况分类评分、体温变化、麻醉并发症发生率和死亡率无显著差异。值得注意的是,与尿液毒理学阴性患者相比,尿液毒理学阳性患者术后拔管的比例显著更低(57.32%对63.83%)。
与尿液毒理学筛查阴性的创伤患者相比,尿液毒理学筛查阳性的创伤患者术中麻醉并发症风险并未增加。然而,我们的结果表明,与无受伤前中毒的患者相比,急性中毒的创伤患者术后机械通气的需求增加。