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2010年9月23日木曜日

(麻)やっぱりTHR/TKRには区域麻酔がよい?

Anesthetic Management and Surgical Site Infections in Total Hip or Knee Replacement   ~A Population-based Study. Anesthesiology. 113(2):279-284, August 2010.

Results: Of the 3,081 sampled patients, 56 patients (1.8%)had 30-day SSIs; 33 (2.8% of all under general anesthesia) of them had general anesthesia, and 23 (1.2% of all under epidural or spinal anesthesia) had epidural or spinal anesthesia (P=0.002). The odds of SSI for patients receiving total hip or knee replacement under general anesthesia were 2.21 (95% CI=1.25–3.90, P=0.007) times higher than those who had the same procedure under epidural or spinal anesthesia, after adjusting for the patient’s age, sex, the year of surgery, comorbidities, surgeon’s age, and hospital teaching status.

THR・TKR手術の麻酔法の違いでのSSI(手術創感染)の差を比較。硬麻/脊麻群は1.2%、全麻群で2.8%の発生率と全麻群で有意にSSIの発生率が多かったということである。高血圧、脂質代謝異常、冠動脈疾患、糖尿病の合併率はいずれも硬麻/脊麻群が有意に多いにも関わらず、の結果である。いろいろと突っ込みどころはあるとは思うが・・・。

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