Häntschel D, Fassl J, Scholz M, Sommer M, Funkat A K, Wittmann M, Ender J
Abteilung für Anästhesie und Intensivtherapie II, Herzzentrum, Universität Leipzig, Strümpellstr. 39, 04289 Leipzig, Deutschland.
Anaesthesist. 2009 Apr;58(4):379-86. doi: 10.1007/s00101-009-1508-1.
In November 2005 a complex, multimodal anesthesia fast-track protocol (FTP) was introduced for elective cardiac surgery patients in the Cardiac Center of the University of Leipzig which included changing from an opioid regime to remifentanil and postoperative treatment in a special post-anesthesia recovery and care unit. The goal was to speed up recovery times while maintaining safety and improving costs.
A total of 421 patients who underwent the FTP and were treated in the special recovery room were analyzed retrospectively. These patients were compared with patients who had been treated by a standard protocol (SP) prior to instituting the FTP. Primary outcomes were time to extubation, length of stay in the intensive care unit (ICU) and treatment costs.
The times to extubation were significantly shorter in the FTP group with 75 min (range 45-110 min) compared to 900 min (range 600-1140 min) in the SP group. Intensive care unit stay and hospital length of stay were also significantly shorter in the FTP group (p<0.01). The reduction of treatment costs of intensive care for FTP patients was 53.5% corresponding to savings of EUR 738 per patient in the FTP group compared with the SP group.
The Leipzig fast-track protocol for cardio-anesthesia including the central elements of switching opiate therapy to remifentanil and switching patient recovery to a special post-anesthesia recovery and care unit, shortened therapy times, is safe and economically effective.
2005年11月，莱比锡大学心脏中心为择期心脏手术患者引入了一种复杂的多模式麻醉快速康复方案（FTP），其中包括从阿片类药物方案改为瑞芬太尼，并在一个特殊的麻醉后恢复和护理单元进行术后治疗。目标是在保持安全性和控制成本的同时加快康复时间。
对在特殊恢复室接受FTP治疗的421例患者进行回顾性分析。将这些患者与在实施FTP之前按照标准方案（SP）治疗的患者进行比较。主要结局指标为拔管时间、重症监护病房（ICU）住院时间和治疗费用。
FTP组的拔管时间显著缩短，为75分钟（范围45 - 110分钟），而SP组为900分钟（范围600 - 1140分钟）。FTP组的重症监护病房住院时间和住院总时长也显著缩短（p<0.01）。与SP组相比，FTP组患者的重症监护治疗成本降低了53.5%，相当于每位患者节省738欧元。
莱比锡心脏麻醉快速康复方案，包括将阿片类药物治疗改为瑞芬太尼以及将患者康复转移至特殊的麻醉后恢复和护理单元等核心要素，缩短了治疗时间，安全且具有经济效益。
