Department of Anesthesiology and Intensive Care, University of Helsinki, Helsinki, Finland.
Curr Opin Anaesthesiol. 2020 Aug;33(4):594-600. doi: 10.1097/ACO.0000000000000890.
To provide aids to deal with increasing amount of several comorbidities in nonoperating room anesthesia (NORA).
New indexes for assessment of comorbidities are described and guidelines for the care of patients with obesity, obstructive sleep apnea, chronic obstructive pulmonary disease (COPD), diabetes and COVID19 in NORA summarized.
In addition to ASA classification, such instruments as Charlson Comorbidity Index, Frailty Index, Surgical Complexity Score and Revised Cardiac Risk could supplement the prospective assessment of the risk of comorbidities. Using institutional protocols patients with significant obesity, obstructive sleep apnea, COPD, diabetes and COVID19 can be safely cared in NORA. However, the individual functioning and the severity are more important than only the number of diseases.
为应对非手术室麻醉（NORA）中日益增多的多种合并症，提供处理方法。
描述了评估合并症的新指标，并总结了 NORA 中肥胖、阻塞性睡眠呼吸暂停、慢性阻塞性肺疾病（COPD）、糖尿病和 COVID-19 患者的护理指南。
除 ASA 分级外，Charlson 合并症指数、脆弱指数、手术复杂程度评分和修订后的心脏风险等工具可补充合并症风险的前瞻性评估。使用机构方案，可安全地在 NORA 中护理患有显著肥胖、阻塞性睡眠呼吸暂停、COPD、糖尿病和 COVID-19 的患者。然而，个体功能和严重程度比疾病数量更为重要。
