Evron Shmuel, Ezri Tiberiu
Department of Anesthesia, Edith Wolfson Medical Center, Tel Aviv University, Holon, Israel.
Curr Opin Anaesthesiol. 2009 Aug;22(4):514-8. doi: 10.1097/ACO.0b013e32832dbac0.
The purpose of this review is to define the responsibility and designation of anesthesia personnel to nonoperating room location anesthesia and their education in this regard. The review will also define the safety standards, guidelines, physical environment, equipment, accreditation, the quality of care and patient and procedural selection.
Anesthesia outside the operating room continues to be a challenging field. With the advances in surgical and anesthetic technology, there is an increasing need for research in the area of office-based anesthetic techniques and for improvement in terms of adherence to safety standards in aiming to decrease morbidity and mortality and increase patient satisfaction.
Complications of anesthesia outside the operating room still persist even in American Society of Anesthesiologists (ASA) status I patients and in accredited facilities with board-certified physicians. The department of anesthesiology taking care of the in-hospital office-based facility has the responsibility to define safe practice standards according to the ASA guidelines regarding education, documentation, guidelines preparation, equipment, standards monitoring, collaboration with other facilities, backup for the personnel in case of emergencies and prolongation of observation of a complicated patient in the postanesthesia care unit. Office-based facilities outside the hospital should comply with all federal, state, local laws and regulations. Such precautions will enhance safety, efficiency and reliability of office-based anesthesia inside and outside the hospital.
本综述旨在明确麻醉人员在非手术室麻醉中的职责与定位，以及他们在这方面的教育情况。该综述还将明确安全标准、指南、物理环境、设备、认证、护理质量以及患者和手术选择。
非手术室麻醉仍是一个具有挑战性的领域。随着外科和麻醉技术的进步，对基于办公室的麻醉技术领域的研究需求日益增加，并且在遵守安全标准方面需要改进，以降低发病率和死亡率并提高患者满意度。
即使在美国麻醉医师协会（ASA）分级为I级的患者以及由获得委员会认证的医生在经认可的机构中进行非手术室麻醉时，并发症仍然存在。负责医院内基于办公室的设施的麻醉科有责任根据ASA指南定义安全实践标准，内容涉及教育、文件记录、指南制定、设备、标准监测、与其他机构的协作、紧急情况下为人员提供支持以及在麻醉后护理单元对复杂患者延长观察时间。医院外基于办公室的设施应遵守所有联邦、州和地方法律法规。这些预防措施将提高医院内外基于办公室的麻醉的安全性、效率和可靠性。
