<b><span>Background:</span></b><span> Distal radius fracture surgery is performed under general (GA) or regional anesthesia with brachial plexus block (NB). </span><span>Wheth...<b><span>Background:</span></b><span> Distal radius fracture surgery is performed under general (GA) or regional anesthesia with brachial plexus block (NB). </span><span>Whether anesthesia type affects patient outcomes is unclear. </span><span>This study retrospectively compared patient satisfaction between GA and NB after surgery. </span><b><span>Methods: </span></b><span>This was a historical cohort study of 80 (34 GA and 46 NB) patients who underwent volar plate fixation of distal radius fractures. Propensity score analysis was used to generate a set of matched cases (NB) and controls (GA), yielding 14 matched patient-pairs. The simplified patient satisfaction scale was compared for primary outcomes. Secondary outcomes were anesthesia and surgery duration, hospital stay length, adverse events, postoperative analgesic requirement, and wrist range of motion (ROM) 2 weeks and 3 months postoperatively.</span><span> </span><b><span>Results:</span></b><span> After propensity score matching, patients in almost all cases in both groups were “Satisfied” (effect size: 0.1, p</span><span> </span><span>=</span><span> </span><span>0.572), indicating little significant difference. Significant differences in adverse events and postoperative analgesic use observed before matching disappeared after matching. Anesthesia duration and hospital stay length were significantly shorter in the NB group (effect size: </span><span>-</span><span>1.27 and </span><span>-</span><span>0.77, p</span><span> </span><span>=</span><span> </span><span>0.00074 and p</span><span> </span><span>=</span><span> </span><span>0.0388, respectively), as was surgery duration (effect size: </span><span>-</span><span>0.84, p</span><span> </span><span>=</span><span> </span><span>0.0122) after matching. Similar to before matching, wrist ROM significantly improved in the NB group (effect size: 1.11, p</span><span> </span><span>=</span><span> </span><span>0.0279) in the early postoperative period, but the difference disappeared at 3 months postoperatively.</span><span> </span><b><span>Conclusions:</span></b><span> Patient satisfaction between distal radius fracture surgery under GA and NB was similar. Nerve block could help shorten hospital stay length and surgery duration and improve postoperative functional recovery.</span>展开更多
目的:观察直入穿刺法与旁入穿刺法2种不同椎管内麻醉穿刺方法对膝关节镜手术患者的影响。方法:择期行膝关节镜手术120例,ASA Ⅰ~Ⅱ级,按随机数字表法随机分为直入法穿刺组和旁入法穿刺组。均采用一点法即针内针单间隙穿刺技术。观...目的:观察直入穿刺法与旁入穿刺法2种不同椎管内麻醉穿刺方法对膝关节镜手术患者的影响。方法:择期行膝关节镜手术120例,ASA Ⅰ~Ⅱ级,按随机数字表法随机分为直入法穿刺组和旁入法穿刺组。均采用一点法即针内针单间隙穿刺技术。观察每组患者的麻醉起效时间、穿刺成功率、神经异感、硬膜外置管困难发生率、硬膜外导管误入血管发生率、术后腰背痛发生情况,麻醉后1、5、10、30min无创血压、心率、脉搏血氧饱和度。结果:直法与旁入法腰麻硬膜外联合穿刺在麻醉起效时间(5.24±0.4)min vs(5.14±0.6)min、硬膜外置管困难发生率1.7% vs 1.7%、硬膜外导管误入血管发生率3.4% vs 1.7%、神经异感发生率3.4% vs 3.4%无显著性差异(P〉0.05)。麻醉后1、5、10、30min SBP、DBP、HR、SpO2,2组间差异无统计学意义(P〉0.05)。旁入法术后腰背痛的发生率75.0%(45/60) vs 23.3%(14/60)及持续时间(2.44±0.8)d vs(2.04±0.7)d明显低于直入法组(x^2=32.042,P=0.000;t=2.195,P=0.004)。结论:2种麻醉穿刺方法均可安全有效地应用于膝关节镜手术;与直入法相比,旁入法腰麻硬膜外联合麻醉术后腰痛发生率低。展开更多
文摘<b><span>Background:</span></b><span> Distal radius fracture surgery is performed under general (GA) or regional anesthesia with brachial plexus block (NB). </span><span>Whether anesthesia type affects patient outcomes is unclear. </span><span>This study retrospectively compared patient satisfaction between GA and NB after surgery. </span><b><span>Methods: </span></b><span>This was a historical cohort study of 80 (34 GA and 46 NB) patients who underwent volar plate fixation of distal radius fractures. Propensity score analysis was used to generate a set of matched cases (NB) and controls (GA), yielding 14 matched patient-pairs. The simplified patient satisfaction scale was compared for primary outcomes. Secondary outcomes were anesthesia and surgery duration, hospital stay length, adverse events, postoperative analgesic requirement, and wrist range of motion (ROM) 2 weeks and 3 months postoperatively.</span><span> </span><b><span>Results:</span></b><span> After propensity score matching, patients in almost all cases in both groups were “Satisfied” (effect size: 0.1, p</span><span> </span><span>=</span><span> </span><span>0.572), indicating little significant difference. Significant differences in adverse events and postoperative analgesic use observed before matching disappeared after matching. Anesthesia duration and hospital stay length were significantly shorter in the NB group (effect size: </span><span>-</span><span>1.27 and </span><span>-</span><span>0.77, p</span><span> </span><span>=</span><span> </span><span>0.00074 and p</span><span> </span><span>=</span><span> </span><span>0.0388, respectively), as was surgery duration (effect size: </span><span>-</span><span>0.84, p</span><span> </span><span>=</span><span> </span><span>0.0122) after matching. Similar to before matching, wrist ROM significantly improved in the NB group (effect size: 1.11, p</span><span> </span><span>=</span><span> </span><span>0.0279) in the early postoperative period, but the difference disappeared at 3 months postoperatively.</span><span> </span><b><span>Conclusions:</span></b><span> Patient satisfaction between distal radius fracture surgery under GA and NB was similar. Nerve block could help shorten hospital stay length and surgery duration and improve postoperative functional recovery.</span>
文摘目的:观察直入穿刺法与旁入穿刺法2种不同椎管内麻醉穿刺方法对膝关节镜手术患者的影响。方法:择期行膝关节镜手术120例,ASA Ⅰ~Ⅱ级,按随机数字表法随机分为直入法穿刺组和旁入法穿刺组。均采用一点法即针内针单间隙穿刺技术。观察每组患者的麻醉起效时间、穿刺成功率、神经异感、硬膜外置管困难发生率、硬膜外导管误入血管发生率、术后腰背痛发生情况,麻醉后1、5、10、30min无创血压、心率、脉搏血氧饱和度。结果:直法与旁入法腰麻硬膜外联合穿刺在麻醉起效时间(5.24±0.4)min vs(5.14±0.6)min、硬膜外置管困难发生率1.7% vs 1.7%、硬膜外导管误入血管发生率3.4% vs 1.7%、神经异感发生率3.4% vs 3.4%无显著性差异(P〉0.05)。麻醉后1、5、10、30min SBP、DBP、HR、SpO2,2组间差异无统计学意义(P〉0.05)。旁入法术后腰背痛的发生率75.0%(45/60) vs 23.3%(14/60)及持续时间(2.44±0.8)d vs(2.04±0.7)d明显低于直入法组(x^2=32.042,P=0.000;t=2.195,P=0.004)。结论:2种麻醉穿刺方法均可安全有效地应用于膝关节镜手术;与直入法相比,旁入法腰麻硬膜外联合麻醉术后腰痛发生率低。