全身麻醉与椎管内麻醉用于人工关节置换术后假体周围感染翻修手术的比较。
General Versus Neuraxial Anesthesia in Revision Surgery for Periprosthetic Joint Infection.
机构信息
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT.
出版信息
J Arthroplasty. 2022 Aug;37(8S):S971-S976. doi: 10.1016/j.arth.2022.01.002. Epub 2022 Jan 10.
BACKGROUND
The purpose of this study was to compare neuraxial and general anesthesia in revision surgery for periprosthetic joint infection (PJI).
METHODS
Patients undergoing revision arthroplasty for PJI were identified in the 2005-2019 American College of Surgeons National Surgical Quality Improvement Program databases. Thirty-day outcomes were compared between general and neuraxial anesthesia. Propensity-score matching and multivariate analysis were used to control patient and procedural variables.
RESULTS
Neuraxial anesthesia was used in 1511 (16.8%) cases and general anesthesia in 7468 (83.2%) cases. Neuraxial anesthesia had a lower risk of any adverse event (odds ratio [OR] 0.70, P < .001), serious adverse events (OR 0.77, P < .001), and minor adverse events (OR 0.66, P < .001). Among 875 reoperations and 1351 readmissions, two had a diagnosis of intraspinal abscess, both occurring after general anesthesia.
CONCLUSIONS
Neuraxial anesthesia was associated with a lower risk of adverse events when compared to general anesthesia in revision surgery for PJI.
背景
本研究旨在比较外周假体关节感染（PJI）翻修手术中采用的脊麻和全身麻醉的效果。
方法
在美国外科医师学院国家手术质量改进计划数据库中确定了 2005 年至 2019 年期间接受 PJI 翻修关节成形术的患者。比较了全身麻醉和脊麻 30 天的结果。采用倾向评分匹配和多变量分析来控制患者和手术变量。
结果
1511 例（16.8%）采用脊麻，7468 例（83.2%）采用全身麻醉。脊麻的不良事件风险较低（比值比[OR]0.70，P<.001）、严重不良事件风险较低（OR0.77，P<.001）和轻微不良事件风险较低（OR0.66，P<.001）。在 875 例再次手术和 1351 例再入院中，有两例诊断为脊髓脓肿，均发生在全身麻醉后。
结论
与全身麻醉相比，外周假体关节感染翻修手术中采用脊麻与不良事件风险降低相关。
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