Awake Spinal Fusion Is Associated with Reduced Length of Stay, Opioid Use, and Time to Ambulation Compared to General Anesthesia: A Matched Cohort Study.
Awake Spinal Fusion Is Associated with Reduced Length of Stay, Opioid Use, and Time to Ambulation Compared to General Anesthesia: A Matched Cohort Study.
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DOI：
10.1016/j.wneu.2023.05.001
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发表时间：
2023-08
影响因子：
2
通讯作者：
Abd-El-Barr, Muhammad M.
中科院分区：
文献类型：
--
作者：
Sykes, David A. W.;Tabarestani, Troy Q.;Chaudhry, Nauman S.;Salven, David S.;Shaffrey, Christopher I.;Bullock, W. Michael;Guinn, Nicole R.;Gadsden, Jeffrey;Berger, Miles;Abd-El-Barr, Muhammad M.
在脊髓麻醉（SA）下进行清醒脊柱融合的兴趣越来越大。支持SA的证据是积极的，尽管有限。作者着手研究脊柱融合术中SA与全身麻醉（GA）对住院时间（LOS）、阿片类药物使用、麻醉时间（TTA）和手术持续时间的影响。作者对一名外科医生在SA与GA下接受腰椎融合术的患者进行了回顾性分析。将SA患者与接受类似手术的人口统计学匹配GA患者进行比较。分析的结局包括手术时间、吗啡毫克当量（MME）阿片类药物使用量、TTA和LOS。10例SA患者与10例GA患者配对。该队列的平均年龄为66.77岁，平均体重指数为27.73 kg/m2，美国麻醉医师协会身体状况评分中位数为3.00。SA患者的LOS低于GA患者（12.87 vs 50.79小时，p=0.001）。SA与GA患者的阿片类药物使用减少（10.76 vs 31.43 MME，p=0.006）。SA与GA患者的TTA缩短（7.22 vs 29.87小时，p=0.022）。与GA患者相比，SA患者的手术持续时间没有显著缩短（139.3 vs 188.2分钟，p=0.089）。这些初步回顾性结果表明，使用SA而不是GA进行腰椎融合与医院LOS减少、阿片类药物使用减少和TTA减少相关。未来的随机前瞻性研究是必要的，以确定是否SA的使用真正导致这些有益的结果。
There is increasing interest in awake spinal fusion under spinal anesthesia (SA). Evidence supporting SA has been positive, albeit limited. The authors set out to investigate the effects of SA vs general anesthesia (GA) for spinal fusion procedures on length of stay (LOS), opioid use, time to ambulation (TTA), and procedure duration. The authors performed a retrospective review of a single surgeon’s patients who underwent lumbar fusions under SA vs GA. SA patients were compared to demographically matched GA counterparts undergoing comparable procedures. Analyzed outcomes include operative time, opioid usage in morphine milligram equivalents (MME), TTA, and LOS. 10 SA patients were matched to 10 GA counterparts. The cohort had a mean age of 66.77, a mean body mass index of 27.73 kg/m2, and a median American Society of Anesthesiologists Physical Status Score of 3.00. LOS was lower in SA vs GA patients (12.87 vs 50.79 hours, p=0.001). Opioid utilization was reduced in SA vs GA patients (10.76 vs 31.43 MME, p=0.006). TTA was reduced in SA vs GA patients (7.22 vs 29.87 hours, p=0.022). Procedure duration was not significantly reduced in SA patients compared to GA patients (139.3 vs 188.2 minutes, p=0.089). These preliminary retrospective results suggest the use of SA rather than GA for lumbar fusions is associated with reduced hospital LOS, reduced opioid utilization, and reduced TTA. Future randomized prospective studies are warranted to determine if SA usage truly leads to these beneficial outcomes.
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影响因子：
3.9
作者：
De Cassai A;Geraldini F;Boscolo A;Pasin L;Pettenuzzo T;Persona P;Munari M;Navalesi P
通讯作者：
Navalesi P
影响因子：
3
作者：
Beschloss, Alexander;Dicindio, Christina;Saifi, Comron
通讯作者：
Saifi, Comron
影响因子：
2.4
作者：
Hathi, Kalpesh;Bigney, Erin;Richardson, Eden;Alugo, Tolu;El-Mughayyar, Dana;Vandewint, Amanda;Manson, Neil;Abraham, Edward;Small, Chris;Thomas, Kenneth;Fisher, Charles G.;Rampersaud, Y. Raja;Hall, Hamilton;McIntosh, Greg;Johnson, Michael G.;Bailey, Christopher S.;Weber, Michael H.;Paquet, Jerome;Kingwell, Stephen;Nataraj, Andrew;Finkelstein, Joel;Kelly, Adrienne;Attabib, Najmedden
通讯作者：
Attabib, Najmedden
DOI：
10.1097/01.blo.0000198726.62514.75
发表时间：
2006-02-01
影响因子：
4.2
作者：
Deyo, Richard A.;Mirza, Sohail K.
通讯作者：
Mirza, Sohail K.
影响因子：
1.4
作者：
McClelland S 3rd;Goldstein JA
通讯作者：
Goldstein JA