Kehlet Henrik, Dahl Jørgen B
Department of Surgical Gastroenterology, Hvidovre University Hospital, DK-2650 Hvidovre, Denmark.
Lancet. 2003 Dec 6;362(9399):1921-8. doi: 10.1016/S0140-6736(03)14966-5.
Surgical injury can be followed by pain, nausea, vomiting and ileus, stress-induced catabolism, impaired pulmonary function, increased cardiac demands, and risk of thromboembolism. These problems can lead to complications, need for treatment in hospital, postoperative fatigue, and delayed convalescence. Development of safe and short-acting anaesthetics, improved pain relief by early intervention with multimodal analgesia, and stress reduction by regional anaesthetic techniques, beta-blockade, or glucocorticoids have provided important possibilities for enhanced recovery. When these techniques are combined with a change in perioperative care a pronounced enhancement of recovery and decrease in hospital stay can be achieved, even in major operations. The anaesthetist has an important role in facilitating early postoperative recovery by provision of minimally-invasive anaesthesia and pain relief, and by collaborating with surgeons, surgical nurses, and physiotherapists to reduce risk and pain.
手术创伤可能会引发疼痛、恶心、呕吐和肠梗阻、应激性分解代谢、肺功能受损、心脏负担加重以及血栓栓塞风险。这些问题可能导致并发症、需要住院治疗、术后疲劳以及康复延迟。开发安全且短效的麻醉剂、通过多模式镇痛早期干预改善疼痛缓解情况以及通过区域麻醉技术、β受体阻滞剂或糖皮质激素减轻应激，为加速康复提供了重要的可能性。当这些技术与围手术期护理的改变相结合时，即使是在大手术中，也能显著加速康复并缩短住院时间。麻醉医生在促进术后早期康复方面发挥着重要作用，通过提供微创麻醉和疼痛缓解，并与外科医生、手术护士和物理治疗师合作以降低风险和减轻疼痛。
