Objective To explore the safety and feasibility of ultra-fast-track anesthesia (UFTA) in transcatheter aortic valve replacement (TAVR) under the concept of enhanced recovery after surgery (ERAS). Methods A retrospective analysis was conducted on the clinical data of patients who underwent TAVR at the First Hospital of Lanzhou University between January 2022 and June 2024. Based on the anesthesia technique, patients were categorized into an ultra-fast-track anesthesia group (group U) and a conventional general anesthesia group (group C). The general patient characteristics, operative duration, length of hospital stay, hospitalization costs, and complications were compared between the two groups. Results A total of 101 patients were ultimately included in the study, comprising 60 males and 41 females, with a mean age of (67.85±7.73) years. Among them, 57 patients were assigned to the group U and 44 to group C. Compared with the group C, the group U showed significantly shorter postoperative extubation time (0.18 h vs. 4.88 h), CCU stay (22 h vs. 37 h), hospital stay (8 d vs.13 d), and lower hospitalization costs (234 300 yuan vs. 251 100 yuan) (P<0.05). In addition, the incidences of pulmonary infection (3.5% vs. 15.9%) and atelectasis (3.5% vs. 15.9%) within 30 days after surgery in the group U were significantly reduced (P<0.05).There was no statistically significant difference in the intraoperative mean arterial pressure, heart rate, or other complications such as postoperative arrhythmia, pervalvular leakage, and cerebral infarction between the two groups (P>0.05). Conclusion UFTA not only ensures the safety of TAVR patients, but also significantly enhances postoperative recovery, shortens recovery time, and optimizes medical resource utilization,.
ObjectiveTo investigate the effect of pulmonary ultrasound on pulmonary complications in ultra-fast-track anesthesia for congenital heart disease surgery.MethodsIn 2019, 60 patients with congenital heart diseases underwent ultra-fast-track anesthesia in Shenzhen Children's Hospital, including 34 males and 26 females with the age ranging from 1 month to 6 years. They were randomly divided into a normal group (group N, n=30) and a lung ultrasound optimization group (group L, n=30). Both groups were used the same anesthesia method and anesthetic compatibility. The group N was anesthetized by ultra-fast-track, the tracheal tube was removed after operation and then the patients were sent to the cardiac intensive care unit (CCU). After operation in the group L, according to the contrast of pre- and post-operational lung ultrasonic examination results, for the patients with fusion of B line, atelectasis and pulmonary bronchus inflating sign which caused the increase of lung ultrasound score (LUS), targeted optimization treatment was performed, including sputum suction in the tracheal tube, bronchoscopy alveolar lavage, manual lung inflation suction, ultrasound-guided lung recruitment and other optimization treatments, and then the patients were extubated after lung ultrasound assessment and sent to CCU. The occurrence of pulmonary complications, LUS, oxygenation index (OI), extubation time, etc were compared between the two groups.ResultsCompared with the induction of anesthesia and 1 hour after extubation of the two groups, the incidence of pulmonary complications in the group L (18 patients, 60.0%) was lower than that in the group N (26 patients, 86.7%, χ2= 4.17, P=0.040) and the rate of patients with LUS score reduction was higher in the group L (15 patients, 50.0%) than that in the group N (7 patients, 23.3%, χ2=4.59, P=0.032). The correlation analysis between the LUS and OI value of all patients at each time point showed a good negative correlation (P<0.05). Extubation time in the group L was longer than that in the group N (18.70±5.42 min vs. 13.47±4.73 min, P=0.001).ConclusionUltra-fast-track anesthesia for congenital heart disease can be optimized by pulmonary ultrasound examination before extubation, which can significantly reduce postoperative pulmonary complications, improve postoperative lung imaging performance, and help patients recover after surgery, and has clinical application value.
