肥胖和麻醉的作用
Lovkesh Arora1, Surangama Sharma, James F Carillo
1Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Current opinion in anaesthesiology
|April 4, 2024
概括
肥胖患者在手术期间面临呼吸系统风险增加. 优化手术前,手术内和手术后的护理,包括呼吸道管理和监测,对于改善这一群体的结果和手术安全至关重要.
科学领域:
- 麻醉学和外科手术期间的医学.
- 腹部外科 腹部外科
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 在全球范围内,肥胖患者的手术程序正在增加.
- 肥胖带来了独特的挑战,特别是在呼吸系统方面.
- 术后呼吸道并发症是这个患者群体的一个重大问题.
研究的目的:
- 审查肥胖患者呼吸系统问题的病理生理学.
- 突出了手术前评估和手术内管理的重要性.
- 讨论优化呼吸道管理和氧化以预防并发症的策略.
主要方法:
- 关于肥胖和外科手术后呼吸道并发症的当前文献的综述.
- 对手术前评估协议的讨论.
- 对手术内技术的分析,如正极呼气压 (PEEP) 定位.
- 对气道管理和氧化策略的评估.
- 考虑近期在术后监测和药物治疗方面的进展.
主要成果:
- 葡萄糖类1 (GLP-1) 激素因延迟胃排空而影响术前禁食指南.
- 诸如定量四列车 (TOF) 监测,改进的神经肌肉逆转剂和胃超声波等进步提高了外科手术期间的护理.
- 门诊外科中心正在安全地管理以前被认为是高风险的复杂肥胖病例.
结论:
- 肥胖患者患上术后并发症的风险更高,主要是呼吸道.
- 进行全面的手术前评估至关重要.
- 有效的手术内管理和术后支持对于患者的安全和改善结果至关重要.
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