Mosa Adam, Somasundaram Mithila, Ferdosi Diba Vahidi, Davidge Kristen, Clarke Howard M, Ho Emily S, Kwan-Wong Terence
Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada.
Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Plast Surg (Oakv). 2024 Aug;32(3):384-388. doi: 10.1177/22925503221134813. Epub 2022 Nov 17.
For infants with ulnar polydactyly, surgical removal of the supernumerary digit can be performed under general or local anesthetic. This study evaluated the wait times, surgical duration, and sedation times associated with performing the procedure under local versus general anesthetic in infants with ulnar polydactyly. The databases of three surgeons at our institution were reviewed for children less than 2 years of age who underwent surgery for non-syndromic ulnar polydactyly. Data collection included patient demographics, wait times, duration of surgery and sedation and complications. The study included children (n = 55) who received treatment under local (n = 22) or general (n = 33) anesthesia. The wait times for the local anesthetic group were significantly shorter than the general anesthetic group (p < 0.05) for: referral to first consultation appointment; referral to surgery date, and decision date to surgery date. The duration of surgery (17.9 ± 6.9 vs 36.6 ± 20.2 min) and sedation time (26.3 ± 11.1 vs 74.8 ± 29.1 min) were significantly shorter in the local anaesthetic group (p < 0.05). There were no differences in complication rates between the groups. In this single-institution retrospective analysis, treatment of non-syndromic ulnar polydactyly with local anesthetic and bottle sedation was associated with shorter wait times, and duration of surgery and sedation. III, retrospective chart review and quality improvement initiative.
对于患有尺侧多指畸形的婴儿,可在全身麻醉或局部麻醉下进行多指切除手术。本研究评估了在局部麻醉与全身麻醉下对患有尺侧多指畸形的婴儿进行该手术的等待时间、手术时长和镇静时间。我们回顾了本机构三位外科医生的数据库,以查找接受非综合征性尺侧多指畸形手术的2岁以下儿童。数据收集包括患者人口统计学信息、等待时间、手术和镇静时长以及并发症情况。该研究纳入了接受局部麻醉(n = 22)或全身麻醉(n = 33)治疗的儿童(n = 55)。在以下方面,局部麻醉组的等待时间显著短于全身麻醉组(p < 0.05):转诊至首次会诊预约的时间;转诊至手术日期的时间,以及决定手术日期至手术日期的时间。局部麻醉组的手术时长(17.9 ± 6.9 vs 36.6 ± 20.2分钟)和镇静时间(26.3 ± 11.1 vs 74.8 ± 29.1分钟)显著更短(p < 0.05)。两组之间的并发症发生率没有差异。在这项单机构回顾性分析中,采用局部麻醉和奶瓶镇静治疗非综合征性尺侧多指畸形与更短的等待时间、手术时长和镇静时间相关。III,回顾性病历审查和质量改进举措。