Götz H
Institut für Anästhesiologie, Universität Erlangen-Nrnberg.
Ther Umsch. 1991 Jun;48(6):400-5.
Such partial functions of the respiratory system as ventilation, gas exchange, bronchomotor tone, respiratory regulation, secretion within the airways, mucociliary clearance, etc., are less impaired by such procedures as peridural or spinal anaesthesia than by general anaesthesia. As a result, it is often concluded that regional anaesthesia should always be used preferentially in the case of patients with a pulmonary risk. However, comparative studies have shown that pulmonary morbidity and mortality are little influenced by the anesthetic procedure. For, in the first instance, the incidence of post-operative complications affecting respiration are determined by previous lung pathologies, the age of the patient, and the location and duration of the surgical procedure. These are factors that cannot readily be influenced by anaesthesiological measures. For this reason, the pre-operative diagnostic evaluation and preparation, post-operative prophylaxis and treatment, including the components pain elimination, physiotherapy, respiratory therapy, broncholysis and secretolysis, are more important than the anaesthetic procedure itself.
呼吸系统的诸如通气、气体交换、支气管运动张力、呼吸调节、气道内分泌、黏液纤毛清除等部分功能，与全身麻醉相比，受硬膜外或脊髓麻醉等操作的损害较小。因此，人们常常得出结论，对于有肺部风险的患者，应始终优先使用区域麻醉。然而，比较研究表明，麻醉方法对肺部发病率和死亡率影响很小。因为，首先，影响呼吸的术后并发症发生率取决于先前的肺部病变、患者年龄、手术部位和持续时间。这些因素不易受麻醉措施影响。因此，术前诊断评估和准备、术后预防和治疗，包括消除疼痛、物理治疗、呼吸治疗、支气管溶解和分泌物溶解等组成部分，比麻醉方法本身更重要。
