全膝关节置换术中脊髓麻醉与全身麻醉的手术室时间比较：一项机构回顾

Operating room time comparison between spinal and general anesthesia in total knee arthroplasty: an institutional review.

作者信息

Chandler Kelly, Jacob Roshan, Kuntz Iv George E, Sowers Mackenzie, McGwin Gerald, Naranje Sameer, Kukreja Promil

机构信息

Department of Orthopaedic Surgery, University of Alabama at Birmingham.

Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham.

出版信息

Orthop Rev (Pavia). 2021 Sep 21;13(2):28330. doi: 10.52965/001c.28330. eCollection 2021.

DOI:10.52965/001c.28330

PMID:35478702

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9037657/

Abstract

BACKGROUND

The type of anesthesia used in total knee arthroplasty is one modifiable factor that could save hospital systems time and money. With spinal and general anesthesia having similar outcomes, more weight can be placed on these anesthesia methods' time or money-saving aspects.

OBJECTIVE

This study aims to determine the differences in time expenditure between spinal and general anesthesia for total knee arthroplasty to optimize OR efficiency and reduce costs.

METHODS

A retrospective analysis of 200 unilateral total knee arthroplasty procedures (CPT Code 27447) was performed from Jan 2017 - July 2019 at one institution. 100 of these received spinal anesthesia, and 100 received general anesthesia. Patient charts were reviewed to obtain demographic, surgical, and anesthetic data.

RESULTS

Time to prepare the patient for surgery and total preoperative time was significantly decreased in the general anesthesia group (24.4 minutes vs. 18.5 minutes; p=<0.0001 and 25.4 minutes vs. 20.4 minutes; p=0.012). After surgery, the time to remove the patient from the operating room was significantly decreased in the spinal group (4.8 minutes vs. 7.0 minutes; p= <0.0001). Nonoperative total time was not significantly different between the two groups (49.3 minutes vs. 46.6 minutes; p=0.1127).

CONCLUSION

While there are significant differences in certain operating room time periods between spinal and general anesthesia, these differences are effectively canceled out when considering total operating room time.

摘要

背景

全膝关节置换术中使用的麻醉类型是一个可调节的因素，它可以节省医院系统的时间和金钱。由于脊髓麻醉和全身麻醉的效果相似，因此可以更多地关注这些麻醉方法在节省时间或金钱方面的优势。

目的

本研究旨在确定全膝关节置换术中脊髓麻醉和全身麻醉在时间消耗上的差异，以优化手术室效率并降低成本。

方法

对2017年1月至2019年7月在一家机构进行的200例单侧全膝关节置换手术（CPT编码27447）进行回顾性分析。其中100例接受脊髓麻醉，100例接受全身麻醉。查阅患者病历以获取人口统计学、手术和麻醉数据。

结果

全身麻醉组患者的手术准备时间和术前总时间显著缩短（分别为24.4分钟对18.5分钟；p<0.0001和25.4分钟对20.4分钟；p=0.012）。手术后，脊髓麻醉组患者从手术室转出的时间显著缩短（4.8分钟对7.0分钟；p<0.0001）。两组的非手术总时间无显著差异（49.3分钟对46.6分钟；p=0.1127）。