Tinturier F, Tondriaux A, Lobjoie E, Khoury A, Groshens A, Galy C, Neveu P, Ossart M
Département d'Anesthésie Réanimation B, C.H.R.U., Amiens.
Phlebologie. 1989 Jan-Mar;42(1):59-68.
The introduction of new anesthetic drugs and the option of administering anesthesia to outpatients for venous surgery of the lower limbs have modified the anesthesiologist's strategy. In addition, the final decision depends on the number of attending physicians (family doctor, phlebologist, surgeon, anesthesiologist, and of course, on the patient). The essential elements which determine the choice are: the methods preferred by the anesthesiologist, the patient's wishes, the duration, type and painful nature of the procedure. All types of anesthetic protocols may be employed. General anesthesia is often preferable because of its flexible administration and local anesthesia because it is simple to administer. Loco-regional anesthetics can be substituted for local types of anesthesia in bilateral surgical procedures but these are difficult to administer on an outpatient basis. Development of new drugs such as propofol is tending to give general anesthesia in outpatients an important role once again.
新型麻醉药物的引入以及为下肢静脉手术门诊患者实施麻醉的选择改变了麻醉医生的策略。此外,最终决策取决于主治医生的数量(家庭医生、静脉病学家、外科医生、麻醉医生,当然还有患者)。决定选择的关键因素包括:麻醉医生偏好的方法、患者的意愿、手术时长、类型和疼痛程度。所有类型的麻醉方案均可采用。全身麻醉因其给药方式灵活而常常更受青睐,局部麻醉则因其易于实施而受青睐。在双侧手术中,局部区域麻醉剂可替代局部麻醉类型,但在门诊基础上实施这些麻醉剂很困难。丙泊酚等新药的开发正使全身麻醉在门诊患者中再次发挥重要作用。