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评估接受全踝关节置换术患者的麻醉类型与术后并发症之间的关联。

Evaluating the Association between Anesthesia Type and Postoperative Complications for Patients Receiving Total Ankle Arthroplasty.

机构信息

Department of Anesthesiology, Hospital of the University of Pennsylvania, Philadelphia, Pennysylvania, USA.

George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

出版信息

Iowa Orthop J. 2022 Jun;42(1):113-119.

Abstract

BACKGROUND

Total ankle arthroplasty (TAA) is performed for ankle arthritis and there has been interest investigating which anesthetic method is the best choice in order to optimize perioperative outcomes. In this study, we compared postoperative complications after TAA for patients receiving either 1) general anesthesia alone or 2) general anesthesia plus regional anesthesia.

METHODS

Patients undergoing primary TAA from 2007 to 2018 were identified in a national database. Patients were stratified into 2 cohorts: general anesthesia and general anesthesia combined with regional anesthesia. In this analysis, 30-day wound, cardiac, pulmonary, renal, thromboembolic, and sepsis complications, as well mortality, postoperative transfusion, urinary tract infection, extended length of stay, and reoperation were assessed. Bivariate analyses and multivariable logistical regression were performed.

RESULTS

Of 1,084 total patients undergoing TAA, 878 patients (81.0%) had general anesthesia and 206 (19.0%) had general anesthesia combined with regional anesthesia. Following adjustment, there were no increased risk of postoperative complications in the combined general and regional anesthesia group compared to those who only underwent general anesthesia.

CONCLUSION

Compared to general anesthesia alone, the addition of regional anesthesia to general anesthesia for TAA is not associated with increased risk of complications in the perioperative period. .

摘要

背景

全踝关节置换术(TAA)用于治疗踝关节关节炎,人们一直关注哪种麻醉方法是优化围手术期结果的最佳选择。在这项研究中,我们比较了接受单纯全身麻醉或全身麻醉联合区域麻醉的 TAA 患者的术后并发症。

方法

在一个国家数据库中确定了 2007 年至 2018 年期间接受初次 TAA 的患者。患者分为 2 组:全身麻醉组和全身麻醉联合区域麻醉组。在本分析中,评估了 30 天伤口、心脏、肺部、肾脏、血栓栓塞和脓毒症并发症以及死亡率、术后输血、尿路感染、延长住院时间和再次手术。进行了双变量分析和多变量逻辑回归分析。

结果

在 1084 例接受 TAA 的患者中,878 例(81.0%)接受全身麻醉,206 例(19.0%)接受全身麻醉联合区域麻醉。调整后,与仅接受全身麻醉的患者相比,全身麻醉联合区域麻醉组术后并发症的风险没有增加。

结论

与单纯全身麻醉相比,TAA 中全身麻醉联合区域麻醉并不会增加围手术期并发症的风险。

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