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耳罩和眼罩对骨科手术脊髓麻醉期间丙泊酚镇静效果的影响:一项随机对照试验

Effects of Earmuffs and Eye Masks on Propofol Sedation during Spinal Anesthesia for Orthopedic Surgery: A Randomized Controlled Trial.

作者信息

Park Jin-Woo, Bae Sung Il, Ryu Jungyul, Chung Seung Hyun, Do Sang-Hwan

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea.

Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea.

出版信息

J Clin Med. 2023 Jan 23;12(3):899. doi: 10.3390/jcm12030899.

Abstract

Intravenous sedative drugs are commonly administered during regional anesthesia. However, reducing the excessive use of sedatives while providing adequate sedation is important from the clinical perspective, since the use of sedatives can cause considerable complications. We hypothesized that the application of earmuffs and eye masks would help reduce the sedative dose required to maintain proper sedation by blocking external stimuli. Patients who underwent orthopedic surgery under spinal anesthesia were randomly allocated to the control (no intervention) or intervention group (wearing earmuffs and eye masks). Intravenous sedation was administered using target-controlled infusion of propofol. The target concentration was controlled to maintain a Modified Observer's Assessment of Alertness and Sedation score of 3 or 4. The primary outcome was the intraoperative propofol requirement. We also investigated the incidence of apnea, and patient satisfaction. Propofol requirement was significantly lower in the intervention group than that in the control group (2.3 (2.0-2.7) vs. 3.1 (2.7-3.4) mg·kg·h; < 0.001). Intraoperative apnea occurred less frequently ( = 0.038) and patient satisfaction was higher ( = 0.002) in the intervention group compared to the control group. This study demonstrated that the use of earmuffs and eye masks during sedation was associated with lower propofol requirement and improved sedation quality.

摘要

静脉镇静药物常在区域麻醉期间使用。然而,从临床角度来看,在提供充分镇静的同时减少镇静剂的过度使用很重要,因为使用镇静剂会引发相当多的并发症。我们推测,使用耳罩和眼罩通过阻断外部刺激将有助于减少维持适当镇静所需的镇静剂剂量。接受脊髓麻醉下骨科手术的患者被随机分配至对照组(无干预)或干预组(佩戴耳罩和眼罩)。使用丙泊酚靶控输注进行静脉镇静。控制靶浓度以维持改良的观察者警觉与镇静评分达到3或4分。主要结局是术中丙泊酚需求量。我们还调查了呼吸暂停的发生率以及患者满意度。干预组的丙泊酚需求量显著低于对照组(2.3(2.0 - 2.7)对比3.1(2.7 - 3.4)mg·kg·h;<0.001)。与对照组相比,干预组术中呼吸暂停的发生频率更低(P = 0.038)且患者满意度更高(P = 0.002)。本研究表明,镇静期间使用耳罩和眼罩与较低的丙泊酚需求量及改善的镇静质量相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e19a/9918134/62dcec6a55a1/jcm-12-00899-g001.jpg

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