区域麻醉与全身麻醉对Covid-19患者重症监护住院率、死亡率和肺部并发症的影响

F. Şahin, H. Kocayiğit, Bedirhan Günel, O. Balaban
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摘要

目的对确诊或疑似新型冠状病毒病(COVID-19)需要手术治疗的患者,尚不清楚合适的麻醉方法。本研究旨在比较区域麻醉(RA)与全身麻醉(GA)在COVID-19感染患者的重症监护病房(ICU)入院率、肺部并发症发生率和死亡率方面的差异。材料和方法我们回顾了2020年3月至2021年12月期间的医疗记录,在研究中加入了在RA或GA下手术的COVID-19患者。将患者分为两组:1。在RA和2下手术的患者。在GA下手术的患者。主要结局是ICU住院率、急性肺、肾、肝并发症和围手术期死亡率。结果我们纳入了123例患者。区域麻醉在队列中明显更高。RA下手术97例(78.9%),GA下手术26例(21.1%)。RA组住院率为8.2%,GA组为11.5%。差异无统计学意义(p=0.422)。RA组有6例(6.2%)出现肺部并发症,GA组有2例(7.7%)出现肺部并发症,差异无统计学意义(p=0.535)。两组围手术期死亡率具有可比性(RA组为5.2%,GA组为7.7%)(p=0.535)。结论区域麻醉下新冠肺炎患者肺部并发症、ICU住院率和围手术期死亡率较低;然而,差异并不显著。
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Regional Anesthesia Vs General Anesthesia In Patients With Covid-19: The Effect On Critical Care Admission, Mortality Rates And Pulmonary Complications
Objectives The appropriate anesthesia method in patients requiring surgical treatment with confirmed or suspected new coronavirus disease (COVID-19) is unclear. This study aimed to compare regional anesthesia (RA) with general anesthesia (GA) in patients with COVID-19 infection in terms of admission to intensive care unit (ICU), rate of pulmonary complications, and mortality. Materials and Methods We reviewed medical records between March 2020 and December 2021 added patients with COVID-19 that operated under RA or GA in the study. The patients were assigned into two groups: 1. patients operated under RA and 2. patients operated under GA. Primary outcomes were admission rates to the ICU, acute pulmonary, renal, and hepatic complications, and perioperative mortality rates. Results We included 123 patients in the study. Regional anesthesia was significantly higher in the cohort. 97 (78.9 %) patients were operated under RA and 26 (21.1 %) patients under GA. The admission rate to ICU was 8.2 %in the RA group and 11.5 %in the GA group. The difference was not significant (p=0.422). Pulmonary complications were seen in 6 (6.2 %) patients in the RA group and 2 (7.7 %) patients in the GA group without a significant difference (p=0.535). Perioperative mortality rates were comparable between groups (5.2 %in the RA group vs. 7.7 %in the GA group) (p=0.535). Conclusion Pulmonary complications, ICU admission, and perioperative mortality rates were lower in COVID-19 patients operated under regional anesthesia; however, the differences were not significant.
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