• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Sao Paulo Medical Journal >Continuous spinal anesthesia versus combined spinal epidural block for major orthopedic surgery: prospective randomized study
【24h】

Continuous spinal anesthesia versus combined spinal epidural block for major orthopedic surgery: prospective randomized study

机译：连续性脊柱麻醉与脊柱硬膜外联合阻滞用于大型骨科手术的前瞻性随机研究

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

CONTEXT AND OBJECTIVES: In major orthopedic surgery of the lower limbs, continuous spinal anesthesia (CSA) and combined spinal epidural anesthesia (CSE) are safe and reliable anesthesia methods. In this prospective randomized clinical study, the blockading properties and side effects of CSA were compared with single interspace CSE, among patients scheduled for major hip or knee surgery. DESIGN AND SETTING: Prospective clinical study conducted at the Institute for Regional Anesthesia, Hospital de Base, S?o José do Rio Preto. METHODS: 240 patients scheduled for hip arthroplasty, knee arthroplasty or femoral fracture treatment were randomly assigned to receive either CSA or CSE. Blockades were performed in the lateral position at the L3-L4 interspace. Puncture success, technical difficulties, paresthesia, highest level of sensory and motor blockade, need for complementary doses of local anesthetic, degree of technical difficulties, cardiocirculatory changes and postdural puncture headache (PDPH) were recorded. At the end of the surgery, the catheter was removed and cerebrospinal fluid leakage was evaluated. RESULTS: Seven patients were excluded (three CSA and four CSE). There was significantly lower incidence of paresthesia in the CSE group. The resultant sensory blockade level was significantly higher with CSE. Complete motor blockade occurred in 110 CSA patients and in 109 CSE patients. Arterial hypotension was observed significantly more often in the CSE group. PDPH was observed in two patients of each group. CONCLUSION: Our results suggest that both CSA and CSE provided good surgical conditions with low incidence of complications. The sensory blockade level and hemodynamic changes were lower with CSA.
机译：背景与目的：在下肢的大型骨科手术中，连续脊柱麻醉（CSA）和联合硬膜外硬膜外麻醉（CSE）是安全可靠的麻醉方法。在这项前瞻性随机临床研究中，在计划进行重大髋部或膝部手术的患者中，将CSA的阻断特性和副作用与单间隙CSE进行了比较。设计与地点：前瞻性临床研究在里约热内卢圣何塞医院基地医院区域麻醉研究所进行。方法：240名计划接受髋关节置换术，膝关节置换术或股骨骨折治疗的患者被随机分配接受CSA或CSE。在L3-L4间隙的横向位置进行封锁。记录穿刺成功，技术难题，感觉异常，最高水平的感觉和运动阻滞，需要补充剂量的局麻药，技术难题的程度，心脏循环变化和硬膜后穿刺头痛（PDPH）。手术结束时，拔出导管并评估脑脊液漏出情况。结果：7例患者被排除（3例CSA和4例CSE）。 CSE组的感觉异常发生率显着降低。 CSE导致的感觉阻滞水平明显更高。 110例CSA患者和109例CSE患者发生了完全的运动阻滞。在CSE组中，动脉低血压的发生率更高。在每组的两名患者中观察到PDPH。结论：我们的结果表明，CSA和CSE均可提供良好的手术条件，并发症发生率低。 CSA的感觉阻滞水平和血液动力学变化较低。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号