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神经阻滞降低术后3年死亡率:一项回顾性队列研究。

Nerve block reduces the incidence of 3-year postoperative mortality: a retrospective cohort study.

作者信息

Li Lu, Li Chen Xi, Zhang Hui, Zhang Jiaqiang

机构信息

Department of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China.

出版信息

Front Surg. 2024 Feb 1;11:1284892. doi: 10.3389/fsurg.2024.1284892. eCollection 2024.

Abstract

PURPOSE

A retrospective cohort study was performed to determine the effect of nerve block on the incidence of postoperative mortality in patients with hip replacement.

METHODS

According to the inclusion and exclusion criteria, patients who were undergoing hip replacement for the first time under general or intraspinal anesthesia, classified as ASA class I-IV, and aged ≥65 years were selected. We collected the general data, past medical history, preoperative laboratory test results, perioperative fluid intake and outflow data, perioperative anesthesia and related drug data, postoperative laboratory results, and correlation time index. Patients with preoperative combined nerve block were included in the N group, and those without combined nerve block were included in the NN group. The patients were followed up via telephone call to assess survival outcomes at 3 years after surgery. Propensity score matching and uni- and multivariate analyses were performed to determine the influence of nerve block and other related factors on postoperative mortality.

RESULTS

A total of 743 patients were included in this study, including 262 in the N group and 481 in the NN group. Two hundred five patients in both groups remained after propensity score matching. Main result: Preoperative nerve block was associated with reduced mortality three years after surgery.

CONCLUSION

Nerve block reduces the incidence of 3-year postoperative mortality, and composite nerve block with general anesthesia and neuraxial anesthesia is worthy of promotion.

摘要

目的

进行一项回顾性队列研究,以确定神经阻滞对髋关节置换患者术后死亡率的影响。

方法

根据纳入和排除标准,选择首次在全身麻醉或椎管内麻醉下行髋关节置换术、美国麻醉医师协会(ASA)分级为I-IV级且年龄≥65岁的患者。我们收集了一般资料、既往病史、术前实验室检查结果、围手术期液体出入量数据、围手术期麻醉及相关用药数据、术后实验室检查结果以及相关时间指标。术前联合神经阻滞的患者纳入N组,未联合神经阻滞的患者纳入NN组。通过电话随访患者,评估术后3年的生存结局。采用倾向评分匹配以及单因素和多因素分析,以确定神经阻滞及其他相关因素对术后死亡率的影响。

结果

本研究共纳入743例患者,其中N组262例,NN组481例。倾向评分匹配后两组各有205例患者。主要结果:术前神经阻滞与术后三年死亡率降低相关。

结论

神经阻滞降低了术后3年死亡率的发生率,全身麻醉与椎管内麻醉联合的复合神经阻滞值得推广。

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