肾结石逆行肾内手术中麻醉类型对监视器上手术视野稳定性的影响:一项前瞻性观察试验

Q4 Medicine Medicina Pub Date : 2024-09-02 DOI:10.3390/medicina60091435
Dongwook Won, Sung Yong Cho, Hyun-Joung No, Jiwon Lee, Jin-Young Hwang, Tae Kyong Kim, Jee-Eun Chang, Hyerim Kim, Jae-Hyun Choi, Jung-Man Lee
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引用次数: 0

摘要

背景和目的:逆行肾内手术(RIRS)是一种治疗肾结石的微创技术。逆行肾内手术通过监视器屏幕显示放大的手术部位。由于肾脏靠近横膈膜,呼吸会影响 RIRS 期间手术视野的稳定性。本试验旨在比较脊髓麻醉和全身麻醉的麻醉类型对 RIRS 期间手术视野稳定性的影响。材料和方法:患者被分配到全身麻醉组或脊髓麻醉组。在手术过程中,第一助手根据 10 级数字评分表(0-10)对监视器屏幕上显示的手术视野移动情况进行评分。接下来,主刀医生也对其进行评分。术后,我们评估了所有患者对麻醉方法的不适感。结果34名患者被分配到全身麻醉组,32名患者被分配到脊髓麻醉组。两名外科医生的手术视野振荡等级平均值显示,全身麻醉组比脊髓麻醉组在监视器屏幕上的视野更稳定(3.3 ± 1.6 vs. 5.0 ± 1.6,P < 0.001)。手术不便程度在两组之间没有差异(0.7 ± 1.8 vs. 1.6 ± 2.6,p = 0.114),尽管脊髓麻醉组有更多患者报告不便程度达到 3 级或以上(8.8% vs. 28.1%,p = 0.042)。结论就手术部位的可视化而言,与脊髓麻醉相比,全身麻醉可能会在 RIRS 期间提供更稳定的手术视野,而不会增加麻醉类型引起的不便。
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The Effect of Anesthesia Type on the Stability of the Surgical View on the Monitor in Retrograde Intrarenal Surgery for Renal Stone: A Prospective Observational Trial
Background and Objectives: Retrograde intrarenal surgery (RIRS) is a minimally invasive technique for nephrolithiasis. RIRS is performed via a monitor screen displaying a magnified surgical site. Respiration can affect the stability of the surgical view during RIRS because the kidneys are close to the diaphragm. The purpose of this trial is to compare the effect of anesthesia type on the stability of the surgical view during RIRS between spinal anesthesia and general anesthesia. Materials and Methods: Patients were allocated to the general anesthesia group or spinal anesthesia group. During surgery, movement of the surgical field displayed on the monitor screen was graded by the first assistant on a 10-grade numeric rating scale (0–10). Next, it was also graded by the main surgeon. After surgery, we evaluated the discomfort with the anesthesia method for all patients. Results: Thirty-four patients were allocated to the general anesthesia group and 32 patients to the spinal anesthesia group. The average values of the two surgeons for surgical field oscillation grade showed vision on the monitor screen was more stable in the general anesthesia group than the spinal anesthesia group (3.3 ± 1.6 vs. 5.0 ± 1.6, p < 0.001). The degrees of the inconvenience of the surgery did not differ between the groups (0.7 ± 1.8 vs. 1.6 ± 2.6, p = 0.114), even though more patients reported inconvenience with a grade of 3 or more in the spinal anesthesia group (8.8% vs. 28.1%, p = 0.042). Conclusions: In terms of the visualization of the surgical site, general anesthesia might provide a more stable surgical view during RIRS compared to spinal anesthesia without increasing inconvenience induced by the type of anesthesia.
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来源期刊
Medicina
Medicina Medicine-Medicine (all)
CiteScore
0.10
自引率
0.00%
发文量
66
审稿时长
24 weeks
期刊介绍: Publicada con el apoyo del Ministerio de Ciencia, Tecnología e Innovación Productiva. Medicina no tiene propósitos comerciales. El objeto de su creación ha sido propender al adelanto de la medicina argentina. Los beneficios que pudieran obtenerse serán aplicados exclusivamente a ese fin.
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