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[非手术室麻醉]

[Nonoperating room anesthesia].

作者信息

Kramer J, Malsy M, Sinner B, Graf B M

机构信息

Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.

出版信息

Anaesthesist. 2019 Sep;68(9):594-606. doi: 10.1007/s00101-019-00633-4.

DOI:10.1007/s00101-019-00633-4
PMID:31375866
Abstract

Anesthesia services outside central surgical facilities (nonoperating room anesthesia, NORA) have become more important. Nonoperating room anesthesia is a challenging field with a wide range of patient ages and interventions. The anesthesiologist is caught between the existing expertise in sedation, respiratory and emergency management and the fact that it may be a potentially avoidable cost factor. The efforts of some specialist departments to carry out sedation themselves even with more complex interventions have therefore increased. In order to permanently establish anesthesia here, apart from the pure anesthesiological expertise, a pronounced willingness to interdisciplinary communication and cooperation is necessary. Only in this way can the participating specialist disciplines be convinced of the anesthesiological added value for the patient. Groups of patients requiring special attention include pediatric patients. The care especially for children under 2 years old also requires the particular anesthesiological expertise of the supervising anesthesiologist; however, profound knowledge, for example in cardiac anesthesia, is also required if special interventions are decentrally managed in the cardiac catheterization laboratory.

摘要

中央外科设施之外的麻醉服务(非手术室麻醉,NORA)变得越发重要。非手术室麻醉是一个具有挑战性的领域,涉及广泛的患者年龄范围和干预措施。麻醉医生面临着现有的镇静、呼吸及急救管理专业知识,以及它可能成为一个潜在可避免的成本因素这一现实之间的矛盾。因此,一些专科部门即便面对更复杂的干预措施也自行开展镇静工作的情况有所增加。为了在此永久确立麻醉服务,除了纯粹的麻醉专业知识外,还需要强烈的跨学科沟通与合作意愿。只有这样,参与的专科才能信服麻醉对患者的附加价值。需要特别关注的患者群体包括儿科患者。尤其对于2岁以下儿童的护理,也需要主管麻醉医生具备特殊的麻醉专业知识;然而,如果在心脏导管实验室分散管理特殊干预措施,还需要例如心脏麻醉方面的深厚知识。