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首页> 外文期刊>Journal of children's orthopaedics >Effects of tourniquet use in paediatric lower leg surgery
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Effects of tourniquet use in paediatric lower leg surgery

机译：止血带在儿科小腿手术中的影响

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Background The purpose of this study is to evaluate the use of the tourniquet and its effect on post-operative pain in the paediatric population following lower leg procedures. Methods A retrospective study of paediatric patients (under the age of 18) undergoing inpatient orthopaedic procedure below the knee performed at a single academic institution between 1st December 2013 and 31st January 2019 was conducted. Primary outcome measures of total opioid consumption during hospital stay and pre-operative nerve block utilization were retrieved from the electronic medical record (EMR). Secondary outcome measures of blood loss, tourniquet time, procedure time and length of hospital stay were also retrieved. Student’s t-tests were used to assess statistical significance between two sample means. Results The final analysis included 204 paediatric procedures, 118 of which used a tourniquet and 86 of which did not. Paediatric patients with a tourniquet had significantly more opioid consumption post-operatively in the form of weight-based morphine equivalents/length of stay (p = 0.01) compared to those who had no tourniquet. This held true for males (p = 0.049) and females (p = 0.04) respectively. We did not see an increase in wound complications or return trips to the operating room in the tourniquet cohort. All procedures included an osseous component except one procedure in the non-tourniquet group. Conclusion Minimizing opioid consumption may be achieved by avoiding tourniquet use in paediatric patients with lower leg procedures. In non-anaemic paediatric patients, it is reasonably risk-free to perform these surgeries without the use of tourniquet to decrease opioid dependence in the post-operative period. Level of evidence III
机译：背景技术本研究的目的是评估止血带的使用及其对小腿手术后儿科人群后术后疼痛的影响。方法对膝关节低于2013年12月1日至2019年1月3日期间的膝关节低于膝关节骨科程序的儿科患者（18岁以下）的回顾性研究。从电子医疗记录（EMR）中检索住院期间住院期间和术前神经阻滞利用的总阿片类药物的主要结果措施。还检索了血液损失，止血带时间，手术时间和住院时间长度的次要结果测量。学生的T-Tests用于评估两个样本手段之间的统计学意义。结果终点分析包括204个儿科程序，其中118个，其中止血带和86个没有。与没有止血带的人相比，止血带与止血带的避孕患者患者显着更高的阿片类药物消耗量显着，以体重的吗啡等当量/逗留时间（P = 0.01）。这对男性（P = 0.049）和女性（P = 0.04）持有。我们没有看到伤口并发症的增加或返回止血带队列的手术室。所有过程包括除非止鸟组中的一个程序之外的osse组件。结论最小化阿片类药物消耗可以通过避免患有小腿手术的小儿患者的止血带来实现。在非贫血儿科患者中，在不使用止血带的情况下不能使用止血带来执行这些手术，以减少术后时期的表阿磷依赖性。证据级别III

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