Liu Yijun, Zhu Xiaoyan, Xie Yongqiu, Yan Jianqin, Guo Qulian
Department of Anesthesiology, Xiangya Hospital of Central South University, Hunan, 410008, China.
Int J Surg Case Rep. 2020;75:104-107. doi: 10.1016/j.ijscr.2020.09.010. Epub 2020 Sep 6.
Ambulatory surgery has the advantages of shortening the waiting time for hospitalization and reducing medical expenses. It has been more and more widely used in recent years in China. The patients admitted in Ambulatory Surgery Center are generally in good condition (ASA I-II), with clear diagnosis, short operation time, low operation risk and low incidence of postoperative complications. It is easy to paralyze the medical staff, neglecting the importance of preoperative preparation, and then causing physical and psychological damage to the patient.
We describe the case of a 21-year-old woman, presented with erratic respiratory rate with a maximum of 40 breaths min and a minimum of 7 breaths min after undergoing arthroscopic meniscectomy. The arterial blood gas analysis revealed a disruption of the acid-base homeostasis with respiratory alkalosis and metabolic acidosis, while all other examinations were normal.
Drug-related adverse reactions, emergence agitation or psychiatric factors may have caused the observed symptoms.
Our observations demonstrate that more extensive clinical and psychological examinations prior to surgery involving general anesthesia may help in avoiding anesthesia-related complications, even in young individuals from the Ambulatory Surgery Center.
门诊手术具有缩短住院等待时间和降低医疗费用的优点。近年来在中国得到越来越广泛的应用。门诊手术中心收治的患者一般情况良好(美国麻醉医师协会分级I-II级),诊断明确,手术时间短,手术风险低,术后并发症发生率低。这很容易使医护人员麻痹大意,忽视术前准备的重要性,进而对患者造成身体和心理伤害。
我们描述了一名21岁女性的病例,该患者在接受关节镜半月板切除术后出现呼吸频率不稳定,最高达每分钟40次呼吸,最低为每分钟7次呼吸。动脉血气分析显示酸碱平衡紊乱,伴有呼吸性碱中毒和代谢性酸中毒,而所有其他检查均正常。
药物相关不良反应、苏醒期躁动或精神因素可能导致了观察到的症状。
我们的观察表明,即使对于门诊手术中心的年轻患者,在涉及全身麻醉的手术前进行更广泛的临床和心理检查可能有助于避免麻醉相关并发症。