Dahl Vegard, Raeder Johan
Department of Anaesthesia, Ullevaal University Hospital, Oslo, Norway.
Curr Opin Anaesthesiol. 2003 Oct;16(5):471-6. doi: 10.1097/00001503-200310000-00006.
The purpose of this review is to present recent research into the clinical use of regional anaesthesia techniques in ambulatory surgery. Further, to put into an ambulatory perspective some of the issues recently discussed on the basis and practice of regional anaesthesia in general.
Early discharge with long-acting peripheral nerve blockade seems safe, and discharge of patients who have not voided after surgery is possible under specified terms. The spinal anaesthesia technique may be improved in terms of better and faster recovery characteristics if the dose of local anaesthesia is reduced by adding a small dose of opioid.
Loco-regional techniques are well suited for ambulatory surgery due to less postoperative nausea and pain and possibly less cognitive dysfunction. The different techniques are continuously being refined in order to provide fast discharge readiness, while still maintaining the benefits.
本综述旨在介绍近期关于区域麻醉技术在门诊手术中临床应用的研究。此外,从门诊手术的角度探讨近期在区域麻醉基础和实践方面讨论的一些问题。
长效外周神经阻滞用于早期出院似乎是安全的,并且在特定条件下,术后未排尿的患者也可以出院。如果通过添加小剂量阿片类药物减少局部麻醉药剂量,脊髓麻醉技术在恢复特性方面可能会得到改善,恢复更好更快。
局部区域技术非常适合门诊手术,因为术后恶心和疼痛较少,可能认知功能障碍也较少。不同技术正在不断改进,以实现快速出院准备,同时仍保持其优势。