在门诊关节置换术中使用低剂量高压布比卡因进行脊柱麻醉。

James T Layson, Matthew C Jackson, Adrienne J Wells, Kathryn Mabee, Jeffrey H DeClaire, Nicholas B Frisch
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引用次数: 0

摘要

简介随着门诊手术中心(ASC)的兴起,麻醉后迅速恢复运动和感觉至关重要。本研究旨在评估低剂量单次高压布比卡因用于门诊关节置换术患者脊髓麻醉(SA)的安全性和有效性:研究人员审查了 2018 年至 2020 年期间一家 ASC 的数据,该 ASC 有两名接受过关节置换术培训的外科医生,他们审查了所有使用低剂量高压布比卡因的初级关节置换术患者。然后对从ASC记录中收集到的数据进行进一步评估,包括总脊柱阻滞时间、阻滞时长、出院标准时间、视觉模拟量表(VAS)评分和出院时间:227 名接受 244 例初次关节置换术的患者接受了低剂量高压布比卡因的脊柱阻滞治疗。0.75% 布比卡因的用量各不相同:115 名患者接受了 0.8 mL(6 mg),111 名患者接受了 1.0 mL(7.5 mg),17 名患者接受了 1.2 mL(9 mg)。SA总时间平均为144分钟,从麻醉后护理病房到达到运动恢复的平均时间为30分钟。从到达麻醉后护理病房到达到出院标准的平均时间为 89 分钟。出院时的平均 VAS 为 1.44;POD1 的平均 VAS 为 3.0。研究人群中没有出现尿潴留,也没有一过性神经症状的报告:低剂量、单次高压注射布比卡因SA是关节置换术中ASC的有效选择,可快速恢复运动功能,促进快速出院,而且安全、风险相对较低。
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Administration of Low-dose Hyperbaric Bupivacaine for Spinal Anesthesia in the Setting of Outpatient Arthroplasty.

Introduction: With the rise of ambulatory surgery centers (ASCs), rapid motor and sensory recovery after anesthesia is crucial. The purpose of this study was to evaluate the safety and efficacy of low-dose single-shot hyperbaric bupivacaine for spinal anesthesia (SA) for patients undergoing outpatient arthroplasty.

Methods: Data were reviewed from a single ASC from 2018 to 2020 for two arthroplasty-trained surgeons for all patients with primary arthroplasties that had administration of low-dose hyperbaric bupivacaine. Data collected from the ASC records were then further evaluated for total spinal block time, length of blockade, time to discharge criteria, visual analog scale (VAS) scores, and time to discharge.

Results: Two hundred twenty-seven patients undergoing 244 primary arthroplasties received SA with low-dose hyperbaric bupivacaine. The volume of 0.75% bupivacaine varied: 115 patients received 0.8 mL (6 mg), 111 patients received 1.0 mL (7.5 mg), and 17 patients received 1.2 mL (9 mg). Total SA time averaged 144 minutes with a mean of 30 minutes from post anesthesia care unit arrival to motor recovery. The mean time from post anesthesia care unit arrival to discharge criteria was 89 minutes. The average VAS at discharge was 1.44; the average VAS on POD1 was 3.0. No episodes of urinary retention and no reports of transient neurologic symptoms were noted in the study population.

Conclusion: Low-dose, single-shot hyperbaric bupivacaine SA is an effective option in the ASC for arthroplasty, providing a fast return of motor function, facilitating rapid discharge, and is safe with a relatively low-risk profile.

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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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