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[俯卧位的围手术期影响:麻醉学方面]

[Perioperative effects of the prone position: anesthesiologic aspects].

作者信息

Archer D P, Ravussin P

机构信息

Département d'anesthésiologie, Foothills Hospital, Calgary, Canada.

出版信息

Ann Fr Anesth Reanim. 1998;17(2):172-6. doi: 10.1016/s0750-7658(98)80070-1.

Abstract

The prone position is commonly used for surgery of the spine and the posterior fossa, and is well tolerated by the majority of patients. As long as the abdomen is not compressed, the physiologic impact of this position on cardiorespiratory function is minor, in some cases even less than with the supine position. However extremes of position, particularly of the head and neck, are poorly tolerated and may lead to a variety of severe neurological complications. In addition, several specific forms of pre-existing pathology may predispose the prone patient to major cardiorespiratory complications. In this paper we have systematically reviewed the English and French literature from 1991 to 1997 using Medline Search of peer reviewed journals for the search terms "prone position" and "prone position and venous air embolism". The 330 collected references were reviewed for quality. In combination with review of current standard textbooks these references form the basis for the current report.

摘要

俯卧位常用于脊柱和后颅窝手术,大多数患者对此体位耐受性良好。只要腹部不受压迫,该体位对心肺功能的生理影响较小,在某些情况下甚至小于仰卧位。然而,极端的体位,尤其是头颈部的极端体位,耐受性较差,可能导致各种严重的神经并发症。此外,几种特定形式的原有病理状况可能使俯卧位患者易发生重大心肺并发症。在本文中,我们使用Medline检索同行评审期刊,以“俯卧位”和“俯卧位与静脉空气栓塞”为检索词,系统回顾了1991年至1997年的英文和法文文献。对收集到的330篇参考文献进行了质量评估。结合当前标准教科书的综述,这些参考文献构成了本报告的基础。

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