Tetzner F, Gunnarsson Wendler O, Rackwitz L, Nöth U, Reyle-Hahn S-M
Klinik für Anästhesiologie und Interdisziplinäre Intensivmedizin, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589, Berlin, Deutschland.
Klinik für Orthopädie und Unfallchirurgie, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, Berlin, 13589, Deutschland.
Orthopade. 2020 Apr;49(4):306-312. doi: 10.1007/s00132-020-03890-z.
Whereas only a few years ago the only expectation of skilful anesthesia was an undisturbed execution of surgical procedures, today this has changed to a perioperative responsibility in which all physicians involved in the treatment process try to optimize the existing circumstances and risks of the patient before, during and after surgery. Thus, the tasks for the anesthesiologist have been mainly extended to a rapid recovery strategy with as few side effects as possible, such as nausea and vomiting or postoperative cognitive deficits (POCD). The establishment of evident structures and the introduction of suitable perioperative procedures with the goal of maintaining homeostasis, adequate opioid-sparing pain treatment and rapid postoperative convalescence determine the anesthesiological fast-track concept.
就在几年前，对熟练麻醉的唯一期望还是顺利实施外科手术，而如今这已转变为一项围手术期职责，在此过程中，参与治疗过程的所有医生都试图在手术前、手术中和手术后优化患者的现有状况及风险。因此，麻醉医生的任务主要扩展到了一种快速康复策略，该策略要尽可能减少副作用，比如恶心、呕吐或术后认知功能障碍（POCD）。建立明确的架构并引入合适的围手术期程序，目标是维持体内平衡、进行充分的阿片类药物节省型疼痛治疗以及实现术后快速康复，这些决定了麻醉学的快速康复理念。
