Sullivan Breandan Lawrence
University of Colorado Denver, Denver, CO 80238, USA.
Semin Cardiothorac Vasc Anesth. 2012 Dec;16(4):187-9. doi: 10.1177/1089253212452343. Epub 2012 Jul 22.
Ultra-fast-track anesthesia for cardiac surgery introduces risks to the patient that may be mitigated by transferring the patient to the intensive care unit with a secure airway. These risks include poorly controlled pain leading to catecholamine surges that result in arrhythmias, strain on fresh suture lines, and potentially myocardial ischemia. On the converse side, the patients frequently require titration of potent narcotic pain medicine that can lead to hypoxemia and hypercarbia in the immediate postoperative stage causing myocardial dysfunction. Finally, the economic benefit of ultra-fast-track anesthesia is questionable and until there is a complete cost analysis that includes operating room time, cost of ultra-fast-track medications, and compares the cost of reintubation and delayed surgical operation, it is difficult to weigh in on the cost benefit advocated in the literature.
心脏手术的超快通道麻醉会给患者带来风险，通过将患者转移至气道安全的重症监护病房，这些风险可能会得到缓解。这些风险包括疼痛控制不佳导致儿茶酚胺激增，进而引发心律失常、新缝合线处的张力增加以及潜在的心肌缺血。另一方面，患者术后常需滴定强效麻醉性镇痛药，这可能导致术后即刻出现低氧血症和高碳酸血症，进而引起心肌功能障碍。最后，超快通道麻醉的经济效益存疑，在没有完整的成本分析（包括手术室时间、超快通道药物成本，并比较再次插管和延迟手术的成本）之前，很难对文献中所倡导的成本效益进行权衡。
