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内镜鼻窦和颅底手术中的麻醉技术

Anesthetic Techniques in Endoscopic Sinus and Skull Base Surgery.

作者信息

Amorocho Martha Cordoba, Fat Iuliu

机构信息

Department of Anesthesiology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; Department of Anesthesiology and Critical Care, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.

Department of Anesthesiology, Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225, USA.

出版信息

Otolaryngol Clin North Am. 2016 Jun;49(3):531-47. doi: 10.1016/j.otc.2016.03.004.

Abstract

Endoscopic sinus approach has become one of the most common surgical techniques for endoscopic sinus and skull base surgery. Anesthetic management has an important impact on the overall patient management, from the preoperative assessment and management to the quality of the surgical field and the postoperative recovery. Hemostasis is critical for adequate anatomical endoscopic visualization. Mild controlled hypotension seems to improve the visibility of the surgical field. Reduction of intraoperative bleeding should be considered during the treatment planning. Preoperative preparations include the optimization of comorbidities and cessation of drugs that may inhibit coagulation.

摘要

鼻内镜鼻窦入路已成为鼻内镜鼻窦和颅底手术最常用的手术技术之一。麻醉管理对患者的整体管理具有重要影响,从术前评估和管理到手术视野质量及术后恢复。止血对于充分的鼻内镜解剖可视化至关重要。轻度控制性低血压似乎可改善手术视野的可视性。在治疗规划过程中应考虑减少术中出血。术前准备包括优化合并症以及停用可能抑制凝血的药物。

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