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[围手术期药物管理]

[Perioperative medication management].

作者信息

Gschiel B, Fritsch G, Bock M

机构信息

Abteilung für Anästhesie und Intensivmedizin Klinikum Klagenfurt am Wörthersee, Österreich.

出版信息

Dtsch Med Wochenschr. 2012 Aug;137(34-35):e1-8. doi: 10.1055/s-0032-1305245. Epub 2012 Aug 14.

DOI:10.1055/s-0032-1305245
PMID:22893054
Abstract

The management of chronic medication in the perioperative phase represents as a serious challenge for the involved physicians. Especially patients with elevated ASA-scores frequently suffer from multiple co-morbidities which often need numerous medications. The probability of pharmacological interactions rises with the number of these medications. Moreover it must be taken into consideration that chronic medication potentially interferes with both intravenous and inhaled anesthetics and moreover, bleeding complications are more likely to occur in patients undergoing chronic pharmacotherapy. The aim of this article is to provide a summary of the existing evidence concerning perioperative medication in patients undergoing non-cardiac surgery. Several guidelines and advisories dealing with cardiovascular medication have been published during the last decade. The main scope of these publications was on beta-blockers and other cardiovascular medication. There is less evidence on not-cardiovascular medication as in most cases only case reports and expert opinions are published. Existing epidemiologic studies on this topic are rather heterogeneous.

摘要

围手术期慢性药物的管理对相关医生来说是一项严峻挑战。尤其是美国麻醉医师协会(ASA)评分较高的患者常常患有多种合并症,这通常需要多种药物治疗。药物相互作用的可能性会随着这些药物数量的增加而上升。此外,必须考虑到慢性药物治疗可能会干扰静脉麻醉药和吸入麻醉药,而且接受慢性药物治疗的患者更易出现出血并发症。本文旨在总结有关非心脏手术患者围手术期用药的现有证据。在过去十年中,已经发布了一些关于心血管药物的指南和建议。这些出版物的主要范围是β受体阻滞剂和其他心血管药物。关于非心血管药物的证据较少,因为在大多数情况下,仅发表了病例报告和专家意见。关于这一主题的现有流行病学研究差异较大。

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