Process optimisation: spinal versus general anaesthesia for endourological surgery. A randomised, controlled trial and machine-learning approach.
Background: Data concerning anaesthesia for endourology are rare, and options for it are numerous. Thus, identifying the optimal anaesthesia regimen remains challenging. With this study we aimed to provide the means for selecting optimal anaesthesia for endourology procedures. Methods: This was a ra...
| Publicado en: | Anaesthesiology Intensive Therapy / Anestezjologia, Intensywna Terapia Vol. 56; no. 5; pp. 285 - 295 |
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| Autores principales: | , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Termedia Publishing House
2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=182587939&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 182587939 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16425758 8Z8J jtl: Anaesthesiology Intensive Therapy / Anestezjologia, Intensywna Terapia issn: 16425758 maglogo: N pubinfo: dt: 2024 vid: 56 iid: 5 pid: 24295 pub: Termedia Publishing House place: , <Blank> artinfo: ui: 182587939 182587939 182587939 10.5114/ait.2024.146716 182587939 ppf: 285 ppct: 10 formats: tig: atl: Process optimisation: spinal versus general anaesthesia for endourological surgery. A randomised, controlled trial and machine-learning approach. aug: au: Skitek, Kornel Schittek, Gregor A. Soukup, Jens sug: subj: Surgery, Urologic Anesthesia, Intravenous Anesthesia, Spinal Anesthesia, General Decision Making, Clinical Machine Learning Methods Outcome Assessment Human Germany Male Female Middle Age Aged Aged, 80 and Over Randomized Controlled Trials Random Assignment Tertiary Health Care Comparative Studies Descriptive Statistics Walking Time Perioperative Care Hypotension Prilocaine Therapeutic Use Bupivacaine Therapeutic Use Recovery Arterial Pressure Remifentanil Therapeutic Use Propofol Therapeutic Use Cost Benefit Analysis Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background: Data concerning anaesthesia for endourology are rare, and options for it are numerous. Thus, identifying the optimal anaesthesia regimen remains challenging. With this study we aimed to provide the means for selecting optimal anaesthesia for endourology procedures. Methods: This was a randomised, open-label, controlled study conducted in a single tertiary hospital. Inclusion criteria: American Society of Anesthesiologists (ASA) physical status/risk category I–III, and scheduled surgery time < 60 minutes. Exclusion criteria: contraindications or lack of consent for one of the anaesthesia types, intellectual disabilities, pregnancy, breastfeeding, and refusal to participate. The participants were divided into 3 groups: G1, spinal anaesthesia (SPA) with bupivacaine; G2, SPA with prilocaine; G3, total intravenous anaesthesia (TIVA) with remifentanil and propofol. The primary outcome measure was time to ambulation, while the secondary outcome measures included perioperative hypotension. The results are presented as mean ± SD or median [IQR]. Results: In total, 117 patients completed the study. The time to ambulation (minutes) was significantly different between all groups: 187.95 ± 49.82, 161.05 ± 46.28, and 129.14 ± 63.75 min, for G1, G2 and G3, respectively. The mean arterial pressure drop from baseline during the procedure was most pronounced in G3 (35% [30–44], P < 0.001) and lowest in G2 (18% [12–27], P < 0.001 vs. G3, NS vs. bupivacaine). Machine-learning models were trained and demonstrated satisfactory performance in predicting the time spent in recovery. Conclusions: In the context of endourological surgery, the time required for ambulation was shortest when using TIVA, while SPA with hyperbaric prilocaine provides the closest approximation to optimal anaesthesia. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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