Kang Z Y, Wang L L, Han Y Z, Guo X Y
Department of Anesthesiology, Peking University Third Hospital Yanqing Hospital, Beijing 102100, China.
Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2022 Aug 18;54(4):770-773. doi: 10.19723/j.issn.1671-167X.2022.04.031.
According to literature reports, the injury rate of the athletes in Olympic Winter Games recent years was as high as 10%-14%. Combined with the background of corona virus disease 2019 (COVID-19), the medical insurance work of the 24th Olympic Winter Games held in Beijing had put forward more complicated requirements and more severe challenges. In order to better optimize anesthesia management, this article summarized the perioperative treatment of athletes in Olympic Winter Games, the safety protection strategy of medical staff under general anesthesia, and the potential impact of peri-operative drugs on athletes. Anesthesiologists, as the core members of the rescue team, should be familiar with the particularity of operative anesthesia of athletes, sum up relevant experience to ensure the safety of perioperative patients. So all kinds of technical measures should be taken in the process of operation to minimize the indoor pollution caused by the patient's cough. For example, all the patients should wear N95 masks from the ward to the operating room, and after the operation, wear the N95 masks back to the ward. Although the International Olympic Committee had banned more than 200 drugs for participants and athletes who had to strictly follow International Olympic Committee requirements during anesthesia, the athletes were no longer participating in this Olympic Winter Games, so opioids (sufentanil and remifentanil) and glucocorticoid (dexamethasone) could be used according to the actual needs of surgery and anesthesia. Five athletes in Yanqing competition area underwent surgical anesthesia in Peking University Third Hospital Yanqing Hospital. All the five patients received general anesthesia, of whom four underwent orthopaedic surgery and one underwent laparoscopic cholecystectomy. General anesthesia with laryngeal mask airway was the first choice in the five patients. And the pain after orthopaedic surgery was severe and nerve block technique could effectively relieve the pain after surgery. Three patients received ultrasound-guided nerve block analgesia, the postoperative analgesia lasted 36 h. After the operation, non-steroidal anti-inflammatory drug (NSAID) was infused intravenously in the ward and all the patients recovered uneventfully. As the core member of the trauma rescue team, anesthesiologists should be familiar with the particularity of the athletes' surgical anesthesia, do a good job in medical security, and summarize relevant experience to ensure the life safety of the perioperative patients.
据文献报道,近年来冬奥会运动员的受伤率高达10%-14%。结合新型冠状病毒肺炎(COVID-19)背景,在北京举办的第24届冬奥会的医疗保险工作提出了更复杂的要求和更严峻的挑战。为了更好地优化麻醉管理,本文总结了冬奥会运动员围手术期治疗、全身麻醉下医务人员的安全保护策略以及围手术期药物对运动员的潜在影响。麻醉医生作为救援队的核心成员,应熟悉运动员手术麻醉的特殊性,总结相关经验以确保围手术期患者的安全。因此,在手术过程中应采取各种技术措施,尽量减少患者咳嗽引起的室内污染。例如,所有患者从病房到手术室都应佩戴N95口罩,术后再佩戴N95口罩返回病房。尽管国际奥委会已禁止200多种药物用于参赛运动员,且运动员在麻醉期间必须严格遵守国际奥委会的要求,但这些运动员不再参加本届冬奥会,因此可根据手术和麻醉的实际需要使用阿片类药物(舒芬太尼和瑞芬太尼)和糖皮质激素(地塞米松)。延庆赛区的5名运动员在北京大学第三医院延庆医院接受了手术麻醉。5例患者均接受全身麻醉,其中4例行骨科手术,1例行腹腔镜胆囊切除术。5例患者均首选喉罩气道全身麻醉。骨科手术后疼痛剧烈,神经阻滞技术可有效缓解术后疼痛。3例患者接受超声引导下神经阻滞镇痛,术后镇痛持续36小时。术后在病房静脉输注非甾体类抗炎药(NSAID),所有患者均顺利康复。作为创伤救援队的核心成员,麻醉医生应熟悉运动员手术麻醉的特殊性,做好医疗保障工作,总结相关经验以确保围手术期患者的生命安全。