Ivani Giorgio, Walker Isabeau, Enright Angela, Davidson Andrew
Department of Pediatric Anesthesia and Intensive Care, Regina Margherita Children's Hospital, Turin, Italy.
Paediatr Anaesth. 2012 Oct;22(10):947-51. doi: 10.1111/pan.12009.
Pediatric anesthesia is no longer a small subspecialty, but an important sector where developments in the new century have brought effective and safe management to children in the perioperative period. Unfortunately, what is common daily practice in the high-income countries with all the guidelines, checklists, instruments, and dedicated pediatric anesthesiologists is often only a dream in the low- and middle-income countries where the basic anesthesia services for improving the high rate of morbidity and mortality still are lacking. Anesthesia given by nonphysicians, with no monitoring, lack of elementary supplies, poor control of infections and hemorrhage, and no water or electricity are very often the 'usual' conditions. The World Health Organization is working hard to offer teams, basic equipments, and teaching and what is needed to offer children of these countries the same opportunities given in the industrialized countries. Other projects such as the Lifebox Project have a similar aim. This paper outlines some of what organizations are doing around the world, with different strategies all having the same target: safe pediatric anesthesia.
小儿麻醉不再是一个小的亚专业,而是新世纪发展为儿童围手术期带来有效且安全管理的一个重要领域。不幸的是,在高收入国家日常常见的配备所有指南、检查表、器械以及专业小儿麻醉医生的情况,在低收入和中等收入国家往往只是一个梦想,这些国家仍然缺乏改善高发病率和死亡率的基本麻醉服务。由非医生进行麻醉、没有监测、缺乏基本用品、感染和出血控制不佳以及没有水电供应,这些情况常常是“常态”。世界卫生组织正在努力提供团队、基本设备、教学以及为这些国家的儿童提供与工业化国家相同机会所需的一切。其他项目,如生命盒项目,也有类似的目标。本文概述了世界各地一些组织正在开展的工作,不同策略都有同一个目标:安全的小儿麻醉。