Pasch T
Institut für Anästhesiologie, Universitätsspitals Zürich.
Anasth Intensivther Notfallmed. 1989 Feb;24(1):3-10.
For a number of reasons, invasive and non-invasive measuring procedures for monitoring purposes must not be considered to be mutually exclusive alternatives. The transitions between the two are fluid, and their respective advantages and disadvantages frequently complement one another. The complication rate characteristic of a given procedure is the greater, the more invasive this procedure is. For this reason, a non-invasive technique should always be given preference over an invasive method provided it is capable of recording the parameter to be monitored at least as reliably and accurately as the latter. For minimal monitoring during anaesthesia, non-invasive procedures are applied exclusively. These include the monitoring of ventilation (FIO2, pressures, volumes, flows), ECG, measurement of blood pressure employing the cuff method, temperature measurement, and a nerve stimulator for establishing the degree of relaxation. In addition, pulse oximetry and capnography are increasingly becoming accepted elements of basic monitoring. The question as to whether further monitoring procedures need to be employed will depend upon the condition of the patient and the nature and duration of the surgical operation and anaesthesia. Here, preferential use is made of invasive methods of recording pressures and flows (cardiac output) within the circulatory system and of various blood parameters (for example, blood gas analysis). To an increasing extent, they are being supplemented, expanded or replaced by newly developed non-invasive methods. Thus, for example, the time and material requirement for non-invasive blood pressure measurement in the finger by means of servomanometry (Finapres) is reduced as compared with intra-arterial pressure recording.(ABSTRACT TRUNCATED AT 250 WORDS)
由于多种原因,用于监测目的的侵入性和非侵入性测量程序不能被视为相互排斥的替代方法。两者之间的转换是灵活的,它们各自的优缺点常常相互补充。一种给定程序的并发症发生率越高,该程序的侵入性就越强。因此,只要非侵入性技术能够至少与侵入性方法一样可靠和准确地记录要监测的参数,就应始终优先选择非侵入性技术。在麻醉期间进行最小化监测时,仅采用非侵入性程序。这些包括通气监测(FIO2、压力、容量、流量)、心电图、袖带法测量血压、体温测量以及用于确定松弛程度的神经刺激器。此外,脉搏血氧饱和度测定法和二氧化碳监测法越来越成为基本监测的公认组成部分。是否需要采用进一步的监测程序将取决于患者的状况以及手术操作和麻醉的性质与持续时间。在此,优先采用侵入性方法来记录循环系统内的压力和流量(心输出量)以及各种血液参数(例如,血气分析)。它们越来越多地被新开发的非侵入性方法所补充、扩展或替代。例如,与动脉内压力记录相比,通过伺服测压法(Finapres)进行手指非侵入性血压测量所需的时间和材料减少了。(摘要截断于250字)