Abstract：
The utility of arterial lines in microvascular decompression (MVD) is not well described.
To examine the safety and costs of arterial lines compared with noninvasive blood pressure (NIBP) monitoring in MVDs.
We retrospectively reviewed patients undergoing MVD from 2012 to 2020. Patients were grouped by procedure date from 2012 to 2014 and 2015 to 2020, reflecting our institution\'s decreasing trend in arterial line placement around 2014 to 2015. Patient features, intraoperative characteristics, and postoperative complications were collected for all cases. Statistical differences were evaluated using chi-squared analyses and t-tests.
Eight hundred fifty-eight patients underwent MVDs, with 204 between 2012 and 2014 and 654 between 2015 and 2020. Over time, the frequency of arterial line placement decreased from 64.2% to 30.1%, P < .001. Arterial lines involved 11 additional minutes of preincision time, P < .001. Patients with arterial lines required both increased doses and costs of vasoactive medications intraoperatively. Patients receiving arterial lines demonstrated no significant differences in complications compared with patients with NIBP monitoring. On average, patients with arterial lines incurred $802 increased costs per case compared with NIBP monitoring.
NIBP monitoring in MVDs provides neurologically and hemodynamically safe outcomes compared with invasive blood pressure monitoring. For patients without significant cardiopulmonary risk factors, NIBP monitoring may be a cost-effective alternative in MVDs.
To examine the safety and costs of arterial lines compared with noninvasive blood pressure (NIBP) monitoring in MVDs.
We retrospectively reviewed patients undergoing MVD from 2012 to 2020. Patients were grouped by procedure date from 2012 to 2014 and 2015 to 2020, reflecting our institution\'s decreasing trend in arterial line placement around 2014 to 2015. Patient features, intraoperative characteristics, and postoperative complications were collected for all cases. Statistical differences were evaluated using chi-squared analyses and t-tests.
Eight hundred fifty-eight patients underwent MVDs, with 204 between 2012 and 2014 and 654 between 2015 and 2020. Over time, the frequency of arterial line placement decreased from 64.2% to 30.1%, P < .001. Arterial lines involved 11 additional minutes of preincision time, P < .001. Patients with arterial lines required both increased doses and costs of vasoactive medications intraoperatively. Patients receiving arterial lines demonstrated no significant differences in complications compared with patients with NIBP monitoring. On average, patients with arterial lines incurred $802 increased costs per case compared with NIBP monitoring.
NIBP monitoring in MVDs provides neurologically and hemodynamically safe outcomes compared with invasive blood pressure monitoring. For patients without significant cardiopulmonary risk factors, NIBP monitoring may be a cost-effective alternative in MVDs.
摘要：
动脉管路在微血管减压术（MVD）中的应用尚未得到很好的描述。
为了检查MVD中动脉管线的安全性和成本，与无创血压（NIBP）监测相比。
我们回顾性分析了2012年至2020年接受MVD的患者。患者按手术日期从2012年至2014年和2015年至2020年进行分组，反映了我们机构在2014年至2015年动脉导管放置的减少趋势。患者特征,术中特征,收集所有病例的术后并发症。使用卡方分析和t检验评估统计学差异。
800名患者接受了MVD，在2012年至2014年之间为204，在2015年至2020年之间为654。随着时间的推移,动脉线放置的频率从64.2%下降到30.1%，P<.001。动脉线增加了11分钟的切口前时间，P<.001。有动脉管路的患者术中需要增加血管活性药物的剂量和成本。与接受NIBP监测的患者相比，接受动脉管线的患者在并发症方面没有显着差异。平均而言,与NIBP监测相比,有动脉管路的患者每例费用增加了802美元.
与有创血压监测相比，MVD中的NIBP监测可提供神经和血液动力学安全的结果。对于没有明显心肺危险因素的患者，NIBP监测可能是MVD中具有成本效益的替代方案。
为了检查MVD中动脉管线的安全性和成本，与无创血压（NIBP）监测相比。
我们回顾性分析了2012年至2020年接受MVD的患者。患者按手术日期从2012年至2014年和2015年至2020年进行分组，反映了我们机构在2014年至2015年动脉导管放置的减少趋势。患者特征,术中特征,收集所有病例的术后并发症。使用卡方分析和t检验评估统计学差异。
800名患者接受了MVD，在2012年至2014年之间为204，在2015年至2020年之间为654。随着时间的推移,动脉线放置的频率从64.2%下降到30.1%，P<.001。动脉线增加了11分钟的切口前时间，P<.001。有动脉管路的患者术中需要增加血管活性药物的剂量和成本。与接受NIBP监测的患者相比，接受动脉管线的患者在并发症方面没有显着差异。平均而言,与NIBP监测相比,有动脉管路的患者每例费用增加了802美元.
与有创血压监测相比，MVD中的NIBP监测可提供神经和血液动力学安全的结果。对于没有明显心肺危险因素的患者，NIBP监测可能是MVD中具有成本效益的替代方案。
