Montpellier D, Hayek E, Ossart M
Département d'Anesthésie-Réanimation, C.H.R.U., Amiens.
Phlebologie. 1989 Jan-Mar;42(1):7-18; discussion 18-20.
Recently developed in France (1970), pre-anaesthetic consultation continues to gain in importance because of a number of considerations. Psychological considerations: Consultation provides information about the patient to be operated, wins the patient's co-operation for his/her preparation for operation, and takes some of the drama out of surgery and anaesthetic. Medical considerations: More complete pre-operative examination (discovery of hereditary defects, and current medication) carried out by means of a long and very methodical interrogation, difficult to do at the patient's bedside. The best and most accurate possible assessment of the anaesthetic risk will reduce per- and post-operative complications or at least reduce their effects by better prevention and preparation of the patient, notably in the case of patients with respiratory problems, following possible complementary examinations or other specialized consultations. Anaesthetic considerations: By means of the choice and discussion of an anaesthetic technique according to the patient's own wishes, the anaesthetic risk, the type of hospitalization, especially in ambulatory anaesthetic, when pre-anaesthetic consultation is indispensable. Care coordination: The anaesthetist doctor assumes a double role of clinician and coordinator with the surgical team, the other specialists, and especially the general practitioner whose work he will continue when the patient is hospitalized, and who will have a leading role in the pre-operative preparation of the patient, and the realization of complementary examinations often carried out at home. The consultation makes for a per-operative approach which is carried out earlier, is more complete and more humane.
麻醉前会诊于1970年在法国首次开展,由于多方面的考虑,其重要性持续增加。心理方面的考虑:会诊可提供有关手术患者的信息,使患者配合手术准备工作,并减轻手术和麻醉带来的部分心理压力。医学方面的考虑:通过长时间且非常有条理的询问进行更全面的术前检查(发现遗传缺陷和当前用药情况),这在患者床边很难做到。对麻醉风险进行尽可能最佳和准确的评估,将减少围手术期和术后并发症,或者至少通过更好地预防和让患者做好准备来减轻其影响,特别是对于有呼吸问题的患者,在进行可能的补充检查或其他专科会诊之后。麻醉方面的考虑:根据患者自身意愿选择和讨论麻醉技术,考虑麻醉风险、住院类型,尤其是在门诊麻醉中,此时麻醉前会诊必不可少。护理协调:麻醉医生在临床医生和协调员两方面都发挥作用,与手术团队、其他专科医生,特别是全科医生协调,患者住院后其工作将由麻醉医生继续进行,全科医生在患者术前准备以及通常在患者家中进行的补充检查中起主导作用。会诊有助于形成更早、更全面且更人性化的围手术期处理方式。