Comparison of Ultrasound-Guided Caudal Epidural Blocks and Spinal Anesthesia for Anorectal Surgery: A Randomized Controlled Trial.
Comparison of Ultrasound-Guided Caudal Epidural Blocks and Spinal Anesthesia for Anorectal Surgery: A Randomized Controlled Trial.
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DOI：
10.1007/s40122-022-00389-7
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发表时间：
2022-06
期刊：
影响因子：
4
通讯作者：
Zhang, Yang
中科院分区：
文献类型：
--
作者：
Chen, Shibiao;Wei, Aiping;Min, Jia;Li, Lei;Zhang, Yang
关键词：
本研究的目的是观察腰麻（SA）和超声引导骶管硬膜外阻滞（CEB）对肛肠手术患者围手术期满意度的影响。一组106例患者被随机分配接受SA（SA组）或CEB（CEB组），11例患者被排除在外。最后，95例患者被留下，其中SA组48例，CEB组47例用于数据分析。主要终点是患者对麻醉技术质量的满意度。次要结局指标包括术后2、4、8、16、24和48 h静息状态下的术后疼痛、首次镇痛要求的时间、镇痛要求、幻肢综合征（PLS）的发生率、肠功能恢复的时间、Amarantine的时间、术后恶心和呕吐（PONV）的发生率，术中平均动脉压（MAP）较基线降低> 20%，外科医生满意度。与CEB组相比，SA组对麻醉技术质量高度满意的患者比例显著较低（20.8% vs 68.1%）。与SA组相比，CEB组在术后4、8、16和24 h的静息NRS评分显著较低。与CEB组患者相比，SA组患者至首次要求镇痛的时间显著更早。CEB组的镇痛需求、PLS发生率、PONV发生率和术中MAP较基线降低> 20%显著降低。两组在肠功能恢复时间、外科医生满意度或截肢时间方面无显著差异。与腰麻相比，超声引导下的骶管硬膜外阻滞具有更高的患者满意度。本研究于2020年6月12日在中国临床试验注册中心（ChiCTR 2000041026）注册。
The aim of this study is to observe the effect of spinal anesthesia (SA) and ultrasound-guided caudal epidural blocks (CEB) on perioperative satisfaction in patients undergoing anorectal surgery. A group of 106 patients were randomly allocated to receive either SA (the SA group) or CEB (the CEB group), and 11 patients were excluded. Finally, 95 patients were left, with 48 in the SA group and 47 in the CEB group for data analysis. The primary endpoint was patient satisfaction with the quality of their anesthetic technique. The secondary outcome measures included postoperative pain at 2, 4, 8, 16, 24, and 48 h after surgery at rest, time to first analgesic request, analgesia requirements, incidence of phantom limb syndrome (PLS), time until return of bowel function, time to ambulation, incidence of postoperative nausea and vomiting (PONV), intraoperative mean arterial pressure (MAP) reduction > 20% from baseline, and surgeon satisfaction. A significantly lower proportion of patients in the SA group was highly satisfied with the quality of their anesthetic technique compared with the CEB group (20.8% versus 68.1%). NRS scores at rest were significantly lower at 4, 8, 16, and 24 h after surgery in the CEB group compared with the SA group. The time to first analgesic request was significantly earlier for patients in the SA group compared with patients in the CEB group. Analgesia requirements, the incidence of PLS, the incidence of PONV, and intraoperative MAP reduction > 20% from baseline were significantly decreased in the CEB group. There were no significant differences between the groups in time until return of bowel function, surgeon satisfaction, or time to ambulation. Ultrasound-guided caudal epidural blocks have higher patient satisfaction compared with spinal anesthesia. This study was registered in the Chinese Clinical Trial Registry (ChiCTR 2000041026) on 06/12/2020.
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影响因子：
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