成年人心脏手术快速通道麻醉对术后并发症影响的研究进展

Effects of fast-track anesthesia on postoperative complications in adult cardiac surgery

心脏手术快速通道麻醉是一种围手术期管理策略,包括术后早期拔管、早期活动,缩短ICU停留时间及住院时间。早期拔管可提高患者康复质量,减少围手术期并发症发生,显著降低医疗成本同时提高医疗资源利用率。然而有关快速通道麻醉方案的优化策略需进一步探索和发掘。大量临床研究证明快速通道麻醉可降低患者术后并发症(术中知晓、呼吸机相关性肺炎、谵妄、恶心呕吐、二次插管)的发生率,并认为该方案是安全有效的。促进患者术后恢复的围手术期麻醉管理方案与早期气管拔管是快通道成功的关键。

Fast-track cardiac anesthesia (FTCA) is a perioperative management strategy, which includes early tracheal extubation, early mobilization, decreased length of intensive care unit (ICU) and hospital stay. It is well established that early extubation can improve the quality of patient recovery, reduce perioperative complications, and significantly decrease healthcare costs and improve resource utilization. However, the optimized fast-track anesthesia protocol still need to be further explored. Studies indicate that fast-track anesthesia is safe and effective, and can reduce the incidence of postoperative complications (intraoperative awareness, ventilator-associated pneumonia, delirium, nausea, vomiting and reintubation). The key to fast-track success is perioperative anesthetic management and early tracheal extubation that can facilitate patient recovery after surgery.