加强日间手术麻醉临床研究,提高日间手术医疗质量

摘要

Ambulatory surgery is widely practiced in developed countries Since it was first proposed by Dr.James Nicoll.There are significant differences in anesthesia management between ambulatory surgery and hospital surgery.With the development of minimally invasive surgical and anaesthetic techniques,short-acting anesthetics,the use of ambulatory surgery has grown rapidly.Anesthesiologist is a necessary condition for the safety of perioperative patients and the implementation of ambulatory surgery.Anesthesiologist participates in preoperative evaluation and choice of patients,intraoperative anesthesia,safe discharge after operation,as well as the management of postoperative pain and complications in the perioperative period.For successful ambulatory anesthesia,the anesthesiologist must consider various factors relating to the patient and surgery.Patient selection is a particularly important factor.Appropriate surgical and anesthetic techniques shoull be used to minimize postoperative complications,especially postoperative pain,nausea,and vomiting.It has become increasingly important to identify patients at risk of perioperative complications and to use appropriate methods to decrease these risks.Future studies should be focus on data derived from ambulatory surgery patients and prospective,randomized,double -blind studies in a large population of patients in order to first identify the patient at risk and the quality system of ambulatory surgery anesthesia,subsequently to use drugs and techniques that reduce these perioperative risks and perioperative complications,allow quick recovery from anesthesia and improve the quality of ambulatory surgery.%自1909年James Nicoll医师首次提出日间手术概念以来,发达国家广泛开展日间手术. 日间手术麻醉管理与住院患者的麻醉管理存在较大的差异.随着微创手术技术和麻醉技术进步,日间手术发展迅速.麻醉科医生是保障患者围术期安全、实施日间手术的必要条件,麻醉医师参与术前评估与筛选、术中麻醉、术后安全离院以及术后疼痛及并发症的处理.成功和安全开展日间手术麻醉,麻醉医师必须考虑与患者有关的各种因素.选择适当的手术和麻醉技术减少术后并发症,特别是术后疼痛和恶心呕吐是日间手术麻醉的基本要求.识别患者围手术期并发症的风险和使用适当的方法来降低这些风险变得越来越重要.未来的研究应该集中于从日间手术和前瞻性的、随机的、双盲研究获得大量患者的数据,以确定患者的风险因索和日间手术麻醉质量体系,发现减少围手术期风险的药物和技术,以降低围术期并发症,促进患者快速康复,提高日间手术质量.