局部麻醉与脆弱退伍军人脐疝修补术中并发症较少相关。
Local Anesthesia is Associated with Fewer Complications in Umbilical Hernia Repair in Frail Veterans.
机构信息
North Texas VA Healthcare System, Department of Surgery, Dallas, Texas; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas; University of Texas Southwestern, Surgical Center for Outcomes, Implementation, and Novel Interventions (S-COIN), Dallas, Texas.
Department of Anesthesiology, Duke University, Durham, North Carolina.
出版信息
J Surg Res. 2021 Oct;266:88-95. doi: 10.1016/j.jss.2021.04.006. Epub 2021 May 11.
BACKGROUND
The optimal anesthesia modality for umbilical hernia repair is unclear. We hypothesized that using local rather than general anesthesia would be associated with improved outcomes, especially for frail patients.
METHODS
We utilized the 1998-2018 Veterans Affairs Surgical Quality Improvement Program to identify patients who underwent elective, open umbilical hernia repair under general or local anesthesia. We used the Risk Analysis Index to measure frailty. Outcomes included complications and operative time.
RESULTS
There were 4958 Veterans (13%) whose hernias were repaired under local anesthesia. Compared to general anesthesia, local was associated with a 12%-24% faster operative time for all patients, and an 86% lower (OR 0.14, 95%CI 0.03-0.72) complication rate for frail patients.
CONCLUSIONS
Local anesthesia may reduce the operative time for all patients and complications for frail patients having umbilical hernia repair.
背景
脐疝修复的最佳麻醉方式仍不明确。我们假设使用局部麻醉而非全身麻醉与更好的结果相关，尤其是对体弱患者。
方法
我们利用 1998-2018 年退伍军人事务部手术质量改进计划，确定了在全身或局部麻醉下择期行开放脐疝修复的患者。我们使用风险分析指数来衡量虚弱程度。结果包括并发症和手术时间。
结果
有 4958 名退伍军人（13%）接受了局部麻醉下的疝修补术。与全身麻醉相比，所有患者的手术时间平均快 12%-24%，而体弱患者的并发症发生率低 86%（OR 0.14，95%CI 0.03-0.72）。
结论
局部麻醉可能会减少所有患者的手术时间，并降低体弱患者脐疝修复的并发症发生率。
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