Baskett P J
Frenchay Hospital, Bristol, England.
Crit Care Clin. 1990 Jan;6(1):13-24.
Field anesthesia may be required on a routine basis in isolated communities in developing countries and from time to time in military conflicts and entrapment situations. The drawover inhalation method is safe, simple, and effective. The equipment is portable and independent of compressed gas supply. Both the Triservice and PAC apparatuses are satisfactory in clinical use. Air enrichment with low flows of oxygen is required in many cases, and intermittent positive pressure should be used in most patients to enhance pulmonary oxygen uptake. Oxygen may be supplied from an oxygen concentrator instead of cylinders. Total intravenous anesthesia is an alternative to the drawover method. Ketamine, midazolam, vecuronium, and fentanyl combine to produce a satisfactory technique using IPPV, but the method requires practice for satisfactory expertise. The technique is of special value in closed-down conditions. Field anesthesia can be practiced safely and effectively but requires special training to acquire familiarity with the techniques. As field anesthesia may be required even in sophisticated countries for entrapment situations, skill should be maintained by practicing the appropriate techniques on a regular basis. Field anesthetic techniques are not second-rate methods--they are just different.
在发展中国家的偏远地区，以及在军事冲突和被困情况下，可能需要定期进行野外麻醉。面罩吸入法安全、简单且有效。该设备便于携带，无需压缩气体供应。三军联合麻醉装置和小儿麻醉面罩装置在临床使用中都令人满意。在许多情况下，需要用低流量氧气进行空气加氧，并且大多数患者应使用间歇正压通气以增强肺对氧气的摄取。氧气可以由制氧机而不是气瓶供应。全静脉麻醉是面罩吸入法的一种替代方法。氯胺酮、咪达唑仑、维库溴铵和芬太尼联合使用，通过间歇正压通气可产生令人满意的麻醉技术，但该方法需要练习才能熟练掌握。该技术在封闭环境中有特殊价值。野外麻醉可以安全有效地实施，但需要经过特殊培训才能熟悉这些技术。由于即使在发达的国家，被困情况下也可能需要野外麻醉，因此应定期练习适当的技术以保持技能。野外麻醉技术并非二流方法，它们只是有所不同。
