《改善围手术期脑健康:围手术期管理团队关键行动的专家共识》解读

Improving perioperative brain health: Interpretation of the expert consensus review of key actions for the perioperative care team

谵妄和术后认知功能障碍是老年患者最常见的围手术期并发症,且对脑健康有潜在长期影响。近期,ASA邀请18名专家组成国际专家组,审阅2010年1月至2019年4月8部围手术期谵妄和术后认知功能障碍的最佳实践声明和指南后,发布《改善围手术期脑健康:围手术期管理团队关键行动的专家共识》,涵盖教育、认知评估、谵妄筛查、非药物干预、疼痛控制和避免抗精神病药共6条声明,形成一份可被广泛实施的简洁行动清单。该专家共识将有效促进围手术期管理团队的持续改进,达到降低围手术期认知功能障碍发生率的目的。麻醉科医师亟需在围手术期认知功能的评估、干预等方面进行更多的深入探索和研究,以形成可遵循的临床路径和指南,为改善患者预后做出应有的努力。

Delirium and postoperative neurocognitive disorder are the commonest perioperative complications in elderly patients.Recently,as part of the American Society of Anesthesiologists(ASA)Perioperative Brain Health Initiative,an international group of 18 experts was invited to review eight best practice statements and guidelines from January 2010 to April 2019.Thus,"Improving perioperative brain health:an expert consensus review of key actions for the perioperative care team"was released,covering education,cognitive evaluation,delirium screening,non-pharmacologic interventions,pain control and avoidance of antipsychotics,and formed a concise list of actions that can be widely implemented.The expert consensus will effectively promote the continuous improvement of the perioperative management team and achieve the targets of reducing the incidence of perioperative neurocognitive disorder.In order to form clinical paths and guidelines that can be followed,anesthesiologists urgently need to conduct more in-depth exploration on the evaluation and intervention of perioperative cognitive function,which will eventually to improve the prognosis of patients perioperatively.