脆性骨折患者治疗中的麻醉相关问题

Anaesthetic aspects in the treatment of fragility fracture patients.

作者信息

White S M, Foss N B, Griffiths R

机构信息

FRCA, Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom.

Department of Anaesthesiology and Intensive Care Medicine, Hvidovre University Hospital, Kettegård Allé 30, Hvidovre, Denmark.

出版信息

Injury. 2018 Aug;49(8):1403-1408. doi: 10.1016/j.injury.2018.06.027. Epub 2018 Jun 22.

DOI:10.1016/j.injury.2018.06.027

PMID:29958684

Abstract

As longevity increases globally, the number of older, frailer, comorbid patients requiring fragility fracture surgery will increase. Fundamentally, anaesthesia should aim to maintain these patients' pre-fracture cognitive and physiological trajectories and facilitate early (ie day 1) postoperative recovery. This review describes the 10 general principles of anaesthesia for fragility fracture surgery that best achieve these aims: multidisciplinary care, 'getting it right first time', timely surgery, standardisation, sympathetic anaesthesia, avoiding ischaemia, sympathetic analgesia, re-enablement, data collection and training.

摘要

随着全球人均寿命的延长，需要进行脆性骨折手术的老年、体弱且患有多种疾病的患者数量将会增加。从根本上讲，麻醉的目标应是维持这些患者骨折前的认知和生理状态，并促进术后早期（即术后第1天）恢复。本综述阐述了脆性骨折手术麻醉的10项通用原则，这些原则最能实现上述目标：多学科护理、“一次做好”、及时手术、标准化、交感神经阻滞麻醉、避免缺血、交感神经镇痛、功能恢复、数据收集和培训。