Department of Anaesthesia, Perioperative Medicine and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.
Department of Anaesthesia, Perioperative Medicine and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia.
Br J Anaesth. 2022 Sep;129(3):284-289. doi: 10.1016/j.bja.2022.06.008. Epub 2022 Jul 11.
There are two established techniques of delivering general anaesthesia: propofol-based total intravenous anaesthesia (TIVA) and volatile agent-based inhaled anaesthesia. Both techniques are offered as standard of care and have an established safety track record lasting more than 30 years. However, it is not currently known whether the choice of anaesthetic technique results in a fundamentally different patient experience or affects early, intermediate-term, and longer-term postoperative outcomes. This editorial comments on a recently published study that suggests that inhaled volatile anaesthesia might be associated with fewer postoperative surgical complications than propofol-based TIVA for patients undergoing colorectal cancer surgery. We consider the strengths and limitations of the study, place these findings in the context of the broader evidence, and discuss how the current controversies regarding anaesthetic technique can be resolved, thereby helping to bring precision medicine into the modern practice of perioperative care.
基于丙泊酚的全静脉麻醉（TIVA）和基于挥发性麻醉剂的吸入麻醉。这两种技术都作为标准治疗方法提供，并且具有超过 30 年的既定安全记录。然而，目前尚不清楚麻醉技术的选择是否会导致患者体验的根本不同，或者是否会影响术后早期、中期和长期的结果。本社论评论了最近发表的一项研究，该研究表明，对于接受结直肠癌手术的患者，吸入挥发性麻醉剂与基于丙泊酚的 TIVA 相比，术后手术并发症可能更少。我们考虑了这项研究的优势和局限性，将这些发现置于更广泛的证据背景下，并讨论了如何解决目前关于麻醉技术的争议，从而有助于将精准医学引入围手术期护理的现代实践中。
