Young Steven, Shapiro Fred E, Urman Richard D
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School.
Institute for Safety in Office-Based Surgery.
Curr Opin Anaesthesiol. 2018 Dec;31(6):707-712. doi: 10.1097/ACO.0000000000000655.
The purpose of this review is to provide an update on the current knowledge about patient safety and outcomes in the office-based setting. Ambulatory procedures performed outside the hospital are steadily increasing, resulting in an increasing number and complexity of office-based procedures and patient comorbidities over the past two decades. In this review we focus on most recent outcomes studies encompassing different surgical specialties and patient populations.
Rates of complications in the office-based surgical (OBS) setting from the latest publications are similar to, or lower than previously reported studies. Many of the studies published were in the field of plastic surgery, with a few publications on office vascular and dental procedures. The most common complications were haematoma, infection and venous thromboembolism (VTE) and pulmonary embolism. Death was a rare finding, though when it occurred, it was often associated with VTE/pulmonary emboli and abdominoplasties.
Overall, these studies contribute positively to our current understanding of the safety of office-based anaesthesia. As an increasing number of procedures migrate from the hospital setting to ambulatory and office-based environments, it will be critically important to ensure high quality and safe patient care in these settings.
本综述旨在提供有关门诊环境下患者安全及预后的最新知识。过去二十年来，在医院外进行的门诊手术稳步增加，导致门诊手术数量增多、复杂性增加，患者合并症也增多。在本综述中，我们重点关注涵盖不同外科专业和患者群体的最新预后研究。
最新出版物中门诊手术（OBS）环境下的并发症发生率与先前报道的研究相似或更低。许多已发表的研究来自整形外科领域，关于门诊血管手术和牙科手术的出版物较少。最常见的并发症是血肿、感染和静脉血栓栓塞（VTE）以及肺栓塞。死亡情况罕见，不过一旦发生，通常与VTE/肺栓塞及腹壁成形术有关。
总体而言，这些研究对我们目前对门诊麻醉安全性的理解有积极贡献。随着越来越多的手术从医院环境转移到门诊和门诊手术环境，在这些环境中确保高质量和安全的患者护理将至关重要。
