加速康复外科理念下的日间手术麻醉管理  

Anesthesia management for ambulatory surgery under the concept of enhanced recovery after surgery

作　　者：高尊正 冯艳[1] 孙德峰[1] GAO Zunzheng;FENG Yan;SUN Defeng(Department of Anesthesiology,the First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning 11601l,P.R.China)

机构地区：[1]大连医科大学附属第一医院麻醉科,辽宁大连116011

出　　处：《华西医学》2023年第2期170-179,共10页West China Medical Journal

摘　　要：加速康复外科(enhanced recovery after surgery, ERAS)旨在通过多学科参与的循证干预措施改善围手术期结果,ERAS理念的实施已被证明可减少术后并发症与住院时长。ERAS理念下的麻醉管理是日间手术安全与平稳进行的基础。该文总结了国内外最新临床研究证据,从术前优化、麻醉方式选择、通气策略、液体管理、体温支持、疼痛管理、术后恶心呕吐预防、术后营养支持、改善术后睡眠等方面对ERAS理念下的日间手术麻醉管理进行综述,旨在为日间手术的麻醉管理提供参考。Enhanced recovery after surgery(ERAS) is a protocol designed to improve perioperative outcomes by multidisciplinary team with evidence-based interventions. The implementation of ERAS concept has been proved to reduce postoperative complications and hospital stay. The anesthesia management under the concept of ERAS is the basis of safe and smooth ambulatory surgical protocol. This article summarizes the latest clinical evidence at home and abroad,and reviews the preoperative optimization, anesthesia mode selection, ventilation strategies, fluid management,temperature support, pain management, postoperative nausea and vomiting prevention, postoperative nutritional support,and postoperative sleep improvement in the management of anesthesia under ERAS concept, in order to provide a reference for anesthesia management in ambulatory surgery.

关 键 词：加速康复外科 日间手术 围手术期 疼痛管理 术后恶心呕吐 

分 类 号：R197.323[医药卫生—卫生事业管理]