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[后颅窝神经外科手术患者麻醉治疗调查问卷]

[Questionnaire on the anaesthesiology treatment of patients subjected to posterior fossa neurosurgery].

作者信息

Ingelmo Ingelmo I, Fábregas Juliá N, Rama-Maceiras P, Rubio Romero R, Badenes Quiles R, Valencia Sola L, Romero Krauchi O, Honorato C, Hernández Palazón J, Sánchez Ledesma M J

机构信息

Hospital Universitario Ramon y Cajal, Madrid, España.

出版信息

Rev Esp Anestesiol Reanim. 2012 Mar;59(3):118-26. doi: 10.1016/j.redar.2012.02.031. Epub 2012 May 3.

Abstract

OBJECTIVES

To find out, by means of a questionnaire, the procedures used by Spanish anaesthetists in peri-operative management of patients subjected to neurosurgery of the posterior cranial fossa.

MATERIAL AND METHODS

A closed-question type questionnaire was sent to Anaesthesiology Departments with a Neurosurgery Department on the participation of anaesthetists in the peri-operative treatment of patients subjected posterior fossa surgery.

RESULTS

The questionnaire was completed by 42 (57.5%) of the 73 national public hospitals with a Neurosurgery Department. The posterior fossa surgery was performed in the sitting position in 36 hospitals, although it was less frequently used than the lateral decubitus or prone decubitus position. There was little specific neurological monitoring, as well as little use of precordial and/or transcranial Doppler for detecting vascular air embolism. Nitrous oxide was used in less than 10% of the centres, and 15% avoided neuromuscular block when neurophysiological monitoring was used during the surgery. Cardiovascular problems were mentioned as being the most frequent in 29% of the centres, while in the post-operative period the most common complications were, cranial nerve déficit, airway oedema (23%), and post-operative vomiting (47%).

CONCLUSIONS

The results obtained from the questionnaire showed that the sitting position was less used than the prone position in posterior fossa surgery, and that neurophysiological monitoring is during surgery is hardly used.

摘要

目的

通过问卷调查了解西班牙麻醉医生在后颅窝神经外科手术患者围手术期管理中所采用的程序。

材料与方法

向设有神经外科的麻醉科发送了一份封闭式问题问卷,内容涉及麻醉医生参与后颅窝手术患者围手术期治疗的情况。

结果

73家设有神经外科的国立公立医院中有42家(57.5%)完成了问卷。36家医院在后颅窝手术中采用坐位,尽管其使用频率低于侧卧位或俯卧位。很少进行特定的神经监测,用于检测血管空气栓塞的胸前和/或经颅多普勒的使用也很少。不到10%的中心使用氧化亚氮,15%的中心在手术期间使用神经生理监测时避免使用神经肌肉阻滞。29%的中心提到心血管问题最为常见,而在术后,最常见的并发症是颅神经缺损、气道水肿(23%)和术后呕吐(47%)。

结论

问卷调查结果显示,后颅窝手术中坐位的使用频率低于俯卧位,且手术期间很少使用神经生理监测。

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