Comparison of postoperative outcomes after cranial neurosurgery using propofol-based total intravenous anesthesia versus inhalation anesthesia: a nationwide cohort study in South Korea.

IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Korean Journal of Anesthesiology Pub Date : 2024-10-14 DOI:10.4097/kja.24443
Tak Kyu Oh, In-Ae Song, Young-Tae Jeon
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Abstract

Background: We aimed to determine whether propofol-based total intravenous anesthesia (TIVA) is associated with mortality and morbidity following cranial neurosurgery compared with inhalation anesthesia.

Methods: This nationwide, retrospective, population-based cohort study included patients who underwent cranial neurosurgery under general anesthesia between January 1, 2016, and December 31, 2021. The two study endpoints were 90-day mortality and postoperative complications.

Results: In total, 144,506 adult patients were included: 65,442 patients (45.3%) who received TIVA (TIVA group) and 79,064 (54.7%) who received inhalation anesthesia (inhalation anesthesia group). After propensity score (PS) matching, 97,156 patients (48,578 in each group) were included. The 90-day mortality rates after cranial neurosurgery were 14.0% (6,660 / 48,578) in the TIVA group and 14.2% (6,779 / 48,578) in the inhalation anesthesia group. Moreover, the postoperative complication rates following cranial neurosurgery were 47.1% (22,411 / 48,578) and 50.3% (23,912 / 48,578) in the TIVA and inhalation anesthesia groups, respectively. Based on the logistic regression analysis, TIVA was not associated with 90-day mortality compared with inhalation anesthesia (odds ratio [OR]: 0.97, 95% CI: 0.94, 1.01; P = 0.188) in the PS-matched cohort. Logistic regression analysis revealed that the TIVA group had a 12% (OR: 0.88, 95% CI: 0.86, 0.90; P < 0.0.001) lower postoperative complication rate than the inhalation anesthesia group.

Conclusions: There was no significant association between the type of anesthesia and postoperative 90-day mortality in patients who underwent cranial neurosurgery in South Korea. However, propofol-based TIVA was associated with a lower incidence of postoperative complications than inhalation anesthesia.

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使用异丙酚全静脉麻醉与吸入麻醉的颅神经外科术后效果比较:韩国全国范围内的队列研究。
背景:我们旨在确定与吸入麻醉相比,基于异丙酚的全静脉麻醉(TIVA)是否与颅神经外科手术的死亡率和发病率有关:我们旨在确定与吸入麻醉相比,基于异丙酚的全静脉麻醉(TIVA)是否与颅神经外科手术后的死亡率和发病率有关:这项基于人群的全国性回顾性队列研究纳入了2016年1月1日至2021年12月31日期间在全身麻醉下接受颅神经外科手术的患者。研究的两个终点是 90 天死亡率和术后并发症:共有 144,506 名成年患者被纳入研究:结果:共纳入了 144506 名成年患者:65442 名患者(45.3%)接受了 TIVA(TIVA 组),79064 名患者(54.7%)接受了吸入麻醉(吸入麻醉组)。经过倾向评分(PS)匹配后,共纳入了 97,156 名患者(每组 48,578 人)。TIVA组和吸入麻醉组的颅神经外科术后90天死亡率分别为14.0%(6,660人/48,578人)和14.2%(6,779人/48,578人)。此外,TIVA 组和吸入麻醉组的颅神经外科术后并发症发生率分别为 47.1%(22,411 / 48,578)和 50.3%(23,912 / 48,578)。根据逻辑回归分析,在 PS 匹配队列中,与吸入麻醉相比,TIVA 与 90 天死亡率无关(几率比 [OR]:0.97,95% CI:0.94,1.01;P = 0.188)。逻辑回归分析显示,TIVA组的术后并发症发生率比吸入麻醉组低12%(OR:0.88,95% CI:0.86,0.90;P < 0.0.001):结论:在韩国接受头颅神经外科手术的患者中,麻醉类型与术后90天死亡率之间没有明显关联。然而,与吸入麻醉相比,基于异丙酚的TIVA术后并发症发生率更低。
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来源期刊
CiteScore
6.20
自引率
6.90%
发文量
84
审稿时长
16 weeks
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