门诊环境下无需插管的深度镇静用于堕胎的安全性。
The safety of deep sedation without intubation for abortion in the outpatient setting.
机构信息
Planned Parenthood of New York City, 26 Bleecker St., New York, NY 10012, USA.
出版信息
J Clin Anesth. 2011 Sep;23(6):437-42. doi: 10.1016/j.jclinane.2011.05.001. Epub 2011 Aug 9.
STUDY OBJECTIVE
To determine the rate of perioperative pulmonary aspiration in patients undergoing first and second-trimester surgical abortion during deep sedation with propofol, without intubation.
DESIGN
Retrospective review of cases of surgical and anesthetic complications reported to the Office of Quality Management of the surgical facility between August 1, 2001 and April 30, 2008.
SETTING
Large urban surgical abortion outpatient facility.
MEASUREMENTS
The medical records of all surgical abortion patients who underwent hospital transfer were reviewed. From billing records, all patients who underwent abortion during deep sedation were identified. The primary outcome was the rate of perioperative pulmonary aspiration. Secondary outcomes included the rates of other anesthesia-related adverse events resulting in hospital transfer.
MAIN RESULTS
During the 81-month study period, the facility performed 62,125 surgical abortions during deep sedation, including 11,039 second-trimester abortions. Only one patient received endotracheal intubation. No cases of perioperative pulmonary aspiration occurred.
CONCLUSIONS
Deep sedation without intubation is a viable method of anesthesia for both first and second-trimester surgical abortions in the outpatient setting.
研究目的
在没有插管的情况下，使用异丙酚对行第一和第二孕期手术流产的患者进行深度镇静，确定围手术期肺吸入的发生率。
设计
对 2001 年 8 月 1 日至 2008 年 4 月 30 日期间向手术设施质量管理办公室报告的手术和麻醉并发症病例进行回顾性审查。
地点
大型城市手术流产门诊设施。
测量
对所有接受医院转院的手术流产患者的病历进行了回顾。从计费记录中确定了所有在深度镇静下进行流产的患者。主要结局是围手术期肺吸入的发生率。次要结局包括导致医院转院的其他与麻醉相关的不良事件的发生率。
主要结果
在 81 个月的研究期间，该设施在深度镇静下进行了 62125 例手术流产，其中包括 11039 例第二孕期流产。仅 1 例患者接受了气管插管。没有发生围手术期肺吸入。
结论
在门诊环境中，不插管的深度镇静是第一和第二孕期手术流产的可行麻醉方法。
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