Alternative Title橈骨遠位端骨折の外科的治療に対する、腕神経叢ブロック（腋窩アプローチ）と全身麻酔との間の患者満足度の比較
Periodical titleOpen Journal of Anesthesiology
Note (General)type:Thesis
Background: Distal radius fracture surgery is performed under general (GA) or regional anesthesia with brachial plexus block (NB). Whether anesthesia type affects patient outcomes is unclear. This study retrospectively compared patient satisfaction between GA and NB after surgery. Methods: 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. Results: After propensity score matching, patients in almost all cases in both groups were “Satisfied” (effect size: 0.1, p = 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: -1.27 and -0.77, p = 0.00074 and p = 0.0388, respectively), as was surgery duration (effect size: -0.84, p = 0.0122) after matching. Similar to before matching, wrist ROM significantly improved in the NB group (effect size: 1.11, p = 0.0279) in the early postoperative period, but the difference disappeared at 3 months postoperatively. Conclusions: 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.
博士（医学）・乙第1511号・令和3年6月25日
Copyright © 2020 by author(s) andScientific Research Publishing Inc.This work is licensed under the CreativeCommons Attribution InternationalLicense (CC BY 4.0).http://creativecommons.org/licenses/by/4.0/
identifier:Open Journal of Anesthesiology Vol.10 No.12 p.422-434 (2020 Dec)
identifier:21645531
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3944
identifier:Open Journal of Anesthesiology, 10(12): 422-434
DOIinfo:doi/10.4236/ojanes.2020.1012037
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2022-03-06T04:54:00+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション