癌症患者门诊介入放射学手术的麻醉注意事项。

Anesthetic considerations for outpatient interventional radiology procedures for cancer patients.

作者信息

Simon Natalie B, Serafin Joanna, Shah Suken H, Barnett Kara M

机构信息

Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Memorial Sloan Kettering Cancer Center, Josie Robertson Surgery Center, New York, New York, USA.

出版信息

Curr Opin Anaesthesiol. 2025 Aug 1;38(4):383-390. doi: 10.1097/ACO.0000000000001515. Epub 2025 May 20.

Abstract

PURPOSE OF REVIEW

Interventional radiology (IR) has emerged as a vital component of cancer care, offering minimally invasive procedures for diagnosis, therapy, and palliation. The increasing safety and efficacy of these procedures have led to a surge in their adoption, including in nonoperating room anesthesia and outpatient settings.

RECENT FINDINGS

Cancer patients increasingly present with complex medical histories for outpatient IR procedures and require specialized anesthetic care. The decision to perform an IR procedure in an outpatient setting should be based on careful evaluation of patient and procedure factors as well as facility resources, which varies among outpatient hospital settings, office-based labs, and ambulatory surgery centers. Oftentimes, oncology patients undergo repeated or multiple procedures at various points in their diagnostic and treatment course.

SUMMARY

We review the types of settings and cases and the patient selection and anesthetic considerations for outpatient IR procedures in cancer patients. By understanding the unique challenges posed by this patient population, including their increased comorbidity burden, potential treatment-related complications, and the need for tailored anesthetic techniques, anesthesia providers can optimize patient care and minimize perioperative risks.

摘要

综述目的

介入放射学(IR)已成为癌症治疗的重要组成部分,提供用于诊断、治疗和缓解的微创程序。这些程序安全性和有效性的不断提高导致其应用激增,包括在非手术室麻醉和门诊环境中。

最新发现

癌症患者在门诊进行IR程序时,越来越多地伴有复杂的病史,需要专门的麻醉护理。在门诊环境中进行IR程序的决定应基于对患者和程序因素以及设施资源的仔细评估,而这些在门诊医院环境、基于办公室的实验室和门诊手术中心之间各不相同。通常,肿瘤患者在其诊断和治疗过程中的不同阶段会接受重复或多次程序。

总结

我们回顾了癌症患者门诊IR程序的设置类型、病例、患者选择和麻醉注意事项。通过了解这一患者群体所带来的独特挑战,包括其增加的合并症负担、潜在的治疗相关并发症以及对定制麻醉技术的需求,麻醉提供者可以优化患者护理并将围手术期风险降至最低。

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