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胸椎脊髓麻醉——乳腺手术中全身麻醉的有效替代方法:一项随机、非盲法研究。

Thoracic spinal anaesthesia - An effective alternative to general anaesthesia in breast surgeries: A randomised, non-blinded study.

作者信息

Karthik G S, Srinivasan Rangalakshmi, Sudheer R, Amabareesha M, Monisha T S, Kumar M Dilip

机构信息

Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.

出版信息

Indian J Anaesth. 2024 Oct;68(10):902-908. doi: 10.4103/ija.ija_629_24. Epub 2024 Sep 14.

Abstract

BACKGROUND AND AIMS

General anaesthesia (GA) is the preferred modality for breast surgeries; however, neuraxial anaesthesia can be performed in cases where GA poses a significant risk. We hypothesise that neuraxial blockade is a safe and effective alternative to GA in short-duration breast surgeries.

METHODS

This randomised study included 30 patients of the American Society of Anesthesiologists physical status I and II, who were scheduled for elective breast surgeries of a duration of less than 90 min. Group I received thoracic spinal anaesthesia, while in Group II, standardised GA was administered. The primary outcome was the time to the first rescue analgesic, and the secondary outcomes were time to recovery, patient satisfaction and the cost incurred.

RESULTS

The demographic characteristics of both groups were comparable ( > 0.05). The time to first rescue analgesic in Group I was more than in Group II ( = 0.001). Patient satisfaction score was superior in Group I compared to Group II ( = 0.002). The average cost was lower in Group I compared to Group II ( = 0.002). Recovery was quicker in Group I than in Group II ( = 0.001). There were no significant haemodynamic disturbances or major complications in either group.

CONCLUSION

Thoracic spinal anaesthesia is an excellent alternative to GA in terms of analgesic efficacy, patient satisfaction, recovery and cost-effectiveness for short-duration breast surgeries.

摘要

背景与目的

全身麻醉(GA)是乳腺手术的首选麻醉方式;然而,在全身麻醉存在重大风险的情况下可采用神经轴索麻醉。我们假设在短时间乳腺手术中,神经轴索阻滞是全身麻醉的一种安全有效的替代方法。

方法

这项随机研究纳入了30例美国麻醉医师协会身体状况为I级和II级的患者,他们计划接受持续时间少于90分钟的择期乳腺手术。第一组接受胸段脊髓麻醉,而第二组给予标准化全身麻醉。主要结局是首次使用补救镇痛药的时间,次要结局是恢复时间、患者满意度和所产生的费用。

结果

两组的人口统计学特征具有可比性(P>0.05)。第一组首次使用补救镇痛药的时间比第二组更长(P=0.001)。与第二组相比,第一组的患者满意度评分更高(P=0.002)。第一组的平均费用低于第二组(P=0.002)。第一组的恢复比第二组更快(P=0.001)。两组均未出现明显的血流动力学紊乱或重大并发症。

结论

就镇痛效果、患者满意度、恢复情况和成本效益而言,胸段脊髓麻醉是短时间乳腺手术中全身麻醉的极佳替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6ae/11498257/b0411fb45de9/IJA-68-902-g001.jpg

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