Hausman Laurence M, Eisenkraft James B, Rosenblatt Meg A
Department of Anesthesiology, The Mount Sinai Medical Center, New York, NY 10029, USA.
J Clin Anesth. 2008 Jun;20(4):271-5. doi: 10.1016/j.jclinane.2007.11.003.
To determine the safety and efficacy of regional anesthesia techniques when administered in the office-based setting.
Retrospective chart review.
Free-standing orthopedic office with an operating room suite.
A total of 238 patients underwent 242 anesthetics. Types of anesthetics delivered were quantified. Regional anesthetics were further divided into specific nerve blocks. Times from anesthetic start to surgical start and from surgical end to anesthetic end were calculated. Adverse outcomes were ascertained and followed.
Of the 242 anesthetics administered, 123 were peripheral nerve blocks, two were neuraxial blocks, 140 were monitored anesthesia care cases, and 17 were general anesthetics (14 Laryngeal Mask Airway cases, two mask ventilation cases, and one endotracheal intubation). The average times from anesthesia start to surgery start were as follows: monitored anesthesia cases, 19+/-7 min (median, 20 min); regional anesthesia cases, 29+/-11 min (median, 30 min); and general anesthesia cases, 31+/-11 min (median, 30 min). The average time from surgery end to anesthesia end for monitored anesthesia cases was 9+/-3 min (median, 10 min); regional anesthesia, 9+/-3 min (median, 10 min); and general anesthesia, 12+/-4 min (median, 20 min). Two transient nerve injuries occurred, both of which resolved.
On the basis of our experience, we believe that regional anesthesia can be delivered efficiently and safely for orthopedic procedures in the office-based environment, and we encourage its wider use.
确定在门诊环境中实施区域麻醉技术的安全性和有效性。
回顾性病历审查。
设有手术室套房的独立骨科门诊。
共有238例患者接受了242次麻醉。对所实施的麻醉类型进行量化。区域麻醉进一步分为特定的神经阻滞。计算从麻醉开始到手术开始以及从手术结束到麻醉结束的时间。确定并跟踪不良结局。
在242次麻醉中，123次为外周神经阻滞，2次为椎管内阻滞，140次为监护麻醉病例，17次为全身麻醉（14例喉罩通气病例，2例面罩通气病例，1例气管插管病例）。从麻醉开始到手术开始的平均时间如下：监护麻醉病例，19±7分钟（中位数，20分钟）；区域麻醉病例，29±11分钟（中位数，30分钟）；全身麻醉病例，31±11分钟（中位数，30分钟）。监护麻醉病例从手术结束到麻醉结束的平均时间为9±3分钟（中位数，10分钟）；区域麻醉为9±3分钟（中位数，10分钟）；全身麻醉为12±4分钟（中位数，20分钟）。发生了2例短暂性神经损伤，均已恢复。
基于我们的经验，我们认为在门诊环境中，区域麻醉可有效地、安全地用于骨科手术，我们鼓励更广泛地使用。
