Korttila K
Ann Chir Gynaecol Fenn. 1975;64(5):292-8.
To shed light on the practice of outpatient anaesthesia in Finland 126 hospitals performing outpatient surgery were asked about the drugs used and about postoperative care. 64% of the hospitals replied. Intravenous were more popular than inhalation agents. Diazepam (57%), propanidid (52%) and thiopentone (52%) were the most commonly used drugs. Nitrous oxide, mostly in combination with other anaesthetics, diazepam with pethidine, and halothane were used in 48%, 41% and 36% of the hospitals respectively. Divinylether and diethylether were employed in 35% and 15% respectively. Propanidid, thiopentone and diazepam were the first choice in 29%, 21%, and 11% respectively, while divinylether was still the first choice agent in 11%. Most central hospitals used nitrous oxide (82%), thiopentone (65%), halothane (60%), propanidid (50%) and methohexitone (25%). Small hospitals, where anaesthesia was not administered by specialists, most frequently used ethers (divinylether 51%, diethylether 29%), diazepam with pethidine (54%), propanidid (49%) and diazepam alone (34%). After propanidid, thiopentone and methohexitone patients were generally kept in hospital for 3 hours and advised against driving for between 17 to 20 hours. It is concluded that the choice of drugs seems appropriate. However, supplementation with nitrous oxide could reduce the high doses of intravenous anaesthetics used and result in reduced side-effects and more rapid recoveries. The wide use of involved anaesthetic techniques in rural areas stresses the importance of teaching anaesthesiology to general practitioners.
为了解芬兰门诊麻醉的实施情况,我们向126家开展门诊手术的医院询问了所使用的药物及术后护理情况。64%的医院进行了回复。静脉麻醉药比吸入麻醉药更受欢迎。地西泮(57%)、丙泮尼地(52%)和硫喷妥钠(52%)是最常用的药物。一氧化二氮(大多与其他麻醉药合用)、地西泮与哌替啶以及氟烷分别在48%、41%和36%的医院中使用。乙烯醚和乙醚的使用医院分别占35%和15%。丙泮尼地、硫喷妥钠和地西泮分别在29%、21%和11%的医院中作为首选药物,而乙烯醚在11%的医院中仍是首选药物。大多数中心医院使用一氧化二氮(82%)、硫喷妥钠(65%)、氟烷(60%)、丙泮尼地(50%)和甲己炔巴比妥(25%)。在非专科医生实施麻醉的小型医院中,最常使用的是醚类(乙烯醚51%,乙醚29%)、地西泮与哌替啶(54%)、丙泮尼地(49%)和单独使用的地西泮(34%)。使用丙泮尼地、硫喷妥钠和甲己炔巴比妥后,患者一般需住院3小时,并被建议在17至20小时内不要开车。结论是药物选择似乎是合适的。然而,补充一氧化二氮可以减少静脉麻醉药的高剂量使用,从而减少副作用并加快恢复。农村地区广泛使用相关麻醉技术凸显了对全科医生进行麻醉学教学的重要性。