摘要
围手术期麻醉管理是骨科手术加速康复能否顺利实施的关键。为了实施骨科加速康复围手术期麻醉管理的精细化与个体化,推动加速康复外科骨科试点工作的落实,国家卫生健康委加速康复外科专家委员会骨科专家组、中国研究型医院学会骨科加速康复专业委员会、中国康复技术转化及促进会骨科加速康复专业委员会联合麻醉科与相关学科专家成立骨科加速康复系列共识编写专家委员会,以临床问题为导向,遵循循证医学原则,从术前、术中、术后归纳出4个方面的问题:(1)术前(门诊和住院手术前)宣教与评估;(2)合并疾病的术前评估与治疗;(3)麻醉管理原则(麻醉方式选择、控制性降压、术中保温、应用氨甲环酸、自体血液回收、液体管理、术毕转运);(4)术后管理(术后疼痛评估与管理、预防术后恶心呕吐、术后饮食管理、术后早期活动、术后访视)。按照上述4个方面的问题进行文献检索和归纳,结合近5年国内外最新研究进展,通过多次会议交流、在线咨询、反复讨论和修改后形成本共识,期望其为我国骨科加速康复围手术期麻醉管理的多学科协作起到积极的推动作用,最终达到加速患者康复的目的。
Perioperative anesthesia management is crucial to the implementation of enhanced recovery after surgery(ERAS)in orthopaedic surgery.In order to achieve the detailed and individualized perioperative anesthesia management and implement ERAS in orthopaedic surgery,Orthopaedic Expert Group of ERAS profession Committee of National Health Commission,Orthopaedic ERAS profession Committee of Chinese Research Hospital Association,Orthopaedic ERAS profession Committee of China Association of Rehabilitation Technology Transformation and Promotion,together with anesthesiologists and physicians from related disciplines,established a collaborative expert committee for this consensus writing.Focusing on the clinical problems and following evidencebased medicine principles,the experts summarized the following four aspects from pre-operation to post-operation:(1)pre-operative patients’evaluation and education(during outpatient service or before post-hospital surgery);(2)preoperative coexisting diseases evaluation and treatment;(3)anesthetic management content including anesthetic mode,controlled blood pressure reduction,heat preservation,tranexamic acid application,autoblood recycle,fluid management and postoperative transport;(4)postoperative anesthesia management(postoperative pain evaluation and management,prevention of nausea and vomiting,diet management,early rehabilitation activities,postoperative visit).Around these four aspects,literature was searched and induced,and the latest researches of recent five years were referenced.Through repeated conference communication,online consultation,discussions and revisions,this consensus was developed hoping to promote the multidisciplinary cooperation and realize rapid recovery for patients.
出处
《中华骨与关节外科杂志》
2022年第10期726-732,共7页
Chinese Journal of Bone and Joint Surgery
关键词
骨科手术
加速康复外科
围手术期
麻醉管理
Orthopaedic Surgery
Enhanced Recovery After Surgery
Perioperative Period
Anesthesia Management
作者简介
通信作者:刘斌,E-mail:liubinhx@foxmail.com;通信作者:黄宇光,E-mail:garyveijing@163.com;通信作者:邱贵兴,E-mail:qguixing@126.com;通信作者:裴福兴,E-mail:peifuxing@vip.163.com
