Department of Anesthesia and Surgery, First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, China.
The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, China.
BMC Anesthesiol. 2024 Nov 27;24(1):429. doi: 10.1186/s12871-024-02834-w.
To explore whether monitored anesthesia care is more beneficial to the outcome of transcatheter aortic valve implantation.
The research methodology involved comprehensive searches across major databases, including the Cochrane Library, PubMed, Scopus, and Web of Science, covering the period from January 1, 2010, to March 1, 2024. The aim was to identify trials comparing different anesthetic methods for transcatheter aortic valve implantation. The primary outcomes assessed were mortality and length of hospital stay, while secondary outcomes included common complications such as bleeding, stroke, paravalvular leakage, renal failure, and others. Data synthesis was conducted using risk ratios or standardized mean differences, along with 95% confidence intervals. The study protocol was prospectively registered with PROSPERO (CRD42024507749).
A total of 35 trials and 45,616 patients were included in this study. The results showed that monitored anesthesia care significantly reduced the patient's risk of death, shortened the patient's length of hospital stay, and also reduced the risk of common complications such as paravalvular leakage (RR, 0.80; 95% CI: 0.72 to 0.88; p < 0.00001; I = 0) and stroke (RR, 0.80; 95% CI: 0.65 to 0.99; p = 0.04; I = 0).
Monitored anesthesia care has an absolute advantage in patient survival and effectively shortens the length of hospitalization. In addition, it also reduces the risk of complications such as paravalvular leakage and stroke. Monitoring care under anesthesia plays a vital role during TAVI surgery, not only helping to ensure the smooth progress of the surgery and patient safety, but also promoting the patient's recovery and recovery.
探讨监测麻醉护理是否更有利于经导管主动脉瓣植入术的结局。
研究方法包括全面检索主要数据库，包括 Cochrane 图书馆、PubMed、Scopus 和 Web of Science，检索时间范围为 2010 年 1 月 1 日至 2024 年 3 月 1 日。旨在识别比较不同麻醉方法用于经导管主动脉瓣植入术的试验。主要结局评估为死亡率和住院时间，次要结局包括常见并发症，如出血、中风、瓣周漏、肾衰竭等。使用风险比或标准化均数差值以及 95%置信区间进行数据综合。该研究方案前瞻性地在 PROSPERO（CRD42024507749）注册。
共有 35 项试验和 45616 名患者纳入本研究。结果表明，监测麻醉护理显著降低了患者的死亡风险，缩短了患者的住院时间，同时降低了常见并发症（如瓣周漏，RR，0.80；95%CI：0.72 至 0.88；p<0.00001；I=0）和中风（RR，0.80；95%CI：0.65 至 0.99；p=0.04；I=0）的风险。
监测麻醉护理在患者生存方面具有绝对优势，有效缩短了住院时间。此外，还降低了瓣周漏和中风等并发症的风险。在 TAVI 手术中，麻醉监测护理起着至关重要的作用，不仅有助于确保手术的顺利进行和患者的安全，还促进了患者的恢复和康复。
