消化管切除术后的患者进行全身麻醉诱导:对美国麻醉师实践的调查 (PESO-GAIN-S)
Nika Samadzadeh Tabrizi1, Alexander D Shapeton2, Jamel Ortoleva3
1Department of Cardiothoracic Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH, 44113, USA. samadzn2@ccf.org.
麻醉科医生展示了在食道切除术后的患者中诱导全身麻醉的各种方法. 大多数麻醉医生优先考虑吸入风险,但需要实践指南,以获得最佳的外科手术周护理.
科学领域:
- 麻醉学 麻醉学
- 外科手术患者管理
- 胃肠道手术 胃肠道手术
背景情况:
- 每年在美国,成千上万的患者在食道切除术后达到稳定状态.
- 这些患者可能需要全身麻醉进行选择性手术.
- 目前,对于这种人群的全身麻醉诱导,没有确定的指导方针.
研究的目的:
- 调查麻醉学家当前的做法和麻醉学家之间关于在食道切除术后患者的全身麻醉诱导的变化.
- 在这个患者群体中确定影响麻醉管理决策的因素.
主要方法:
- 一项全国性的在线调查分发给美国麻醉学会的23524名成员.
- 该调查收集了有关人口统计学特征和经食道切除术患者麻醉管理策略的数据.
- 根据麻醉师的人口统计数据和对该患者群体的经验,分析和分层对反应进行了分析.
主要成果:
- 共有744名麻醉师 (3.2%的响应率) 完成了调查.
- 输内管是首选的气道管理方法 (87.1%).
- 快速序列诱导 (64.7%) 和反向Trendelenburg位置 (67.7%) 是常见的,特别是在那些经常接触食道切除术后患者中. 麻醉诱导方法根据麻醉师的经验和人口统计数据有很大的不同.
结论:
- 在美国麻醉科医生之间,对于有食道切除病史的患者来说,对全身麻醉诱导的方法存在显著的变化.
- 愿望风险似乎是影响管理决策的首要问题.
- 缺乏标准化的实践指南凸显了在这个独特的患者群体中优化术后护理的未满足需求.
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