择期手术合并阻塞性睡眠呼吸暂停患者的围手术期最佳处理方法。
Best perioperative practices in the management of obstructive sleep apnea patients undergoing ambulatory surgery.
机构信息
Department of Anesthesia and Pain Management, University Health Network, University of Toronto.
Department of Anesthesiology, Women's College Hospital, Toronto, Ontario, Canada.
出版信息
Curr Opin Anaesthesiol. 2024 Dec 1;37(6):644-650. doi: 10.1097/ACO.0000000000001441. Epub 2024 Oct 11.
PURPOSE OF REVIEW
This review is timely due to the increasing prevalence of obstructive sleep apnea (OSA) among patients undergoing ambulatory surgery, necessitating updated perioperative management strategies to improve outcomes and reduce complications.
RECENT FINDINGS
Recent studies emphasize the importance of risk stratification using tools like STOP-Bang, highlighting the association between high-risk OSA and increased perioperative complications. Intraoperative management strategies, including the preference for regional anesthesia and careful monitoring of neuromuscular blockade, have been shown to mitigate risks. Postoperative protocols, particularly continuous monitoring, are crucial in preventing opioid-induced respiratory depression.
SUMMARY
Effective management of OSA in ambulatory surgery requires a multidisciplinary approach, encompassing preoperative screening, tailored intraoperative techniques, and vigilant postoperative monitoring. Implementing guidelines and protocols can significantly enhance patient safety and outcomes.
目的综述
由于在接受日间手术的患者中阻塞性睡眠呼吸暂停（OSA）的患病率不断增加，因此需要更新围手术期管理策略，以改善结果并减少并发症，这使得本篇综述非常及时。
最近的发现
最近的研究强调了使用 STOP-Bang 等工具进行风险分层的重要性，突出了高危 OSA 与围手术期并发症增加之间的关联。术中管理策略，包括偏爱区域麻醉和仔细监测神经肌肉阻滞，已被证明可以降低风险。术后方案，特别是连续监测，对于预防阿片类药物引起的呼吸抑制至关重要。
总结
在日间手术中有效管理 OSA 需要多学科方法，包括术前筛查、量身定制的术中技术以及术后严密监测。实施指南和方案可以显著提高患者的安全性和结果。
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