在麻醉中进行术后管理和监测
Wolfgang Buhre1, Rolf Rossaint
1Department of Anaesthesiology, University Hospital of Aachen, Aachen, Germany. wbuhre@ukaachen.de
Lancet (London, England)
|December 5, 2003
概括
基本的生理监测和在麻醉期间预防低温可以减少患者的伤害. 外科期间的β阻塞剂和神经轴麻醉也可能改善高风险手术患者的结果.
科学领域:
- 麻醉学 麻醉学
- 患者安全 患者安全
- 临界护理医学 临界护理医学
背景情况:
- 麻醉与重大风险有关,包括人为错误,心血管和呼吸道并发症.
- 监测和预防策略对于减轻麻醉相关的发病率和死亡率至关重要.
- 识别和管理风险因素是改善患者治疗结果的关键.
研究的目的:
- 审查在接受麻醉的患者中出现不良结果的已确定的风险因素.
- 讨论生理监测,低温预防和药物干预对患者安全的影响.
- 评估不同类型麻醉在术后死亡率中的作用.
主要方法:
- 关于麻醉中的风险因素和预防策略的文献综述.
- 关于生理监测,温度管理和药理干预措施的证据分析.
- 检查高风险患者亚组中全身麻醉与区域麻醉的数据.
主要成果:
- 基本的心肺呼吸系统监测可能会减少严重事故,尽管直接的结果影响尚未被证明.
- 通过测量体温和积极升温来预防低温,有效地减少了发病率.
- 建议在患有冠状动脉疾病的患者进行外科期β-阻断剂治疗.
- 神经轴麻醉可以减少高风险患者的呼吸和心血管并发症.
结论:
- 实施基本的生理监测和主动升温对于减少麻醉相关并发症至关重要.
- 药理干预措施,如β-阻断剂和区域麻醉技术,在改善特定患者群体的治疗结果方面表现有前途.
- 需要进一步的研究来澄清监测的直接影响和麻醉类型对外科手术期间死亡率的作用.
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