保留自主呼吸的全身麻醉方式在胸科手术中的应用研究进展
Research progress on the application of general anesthesia with spontaneous breathing preservation in thoracic surgery
吴志勇 1莫娇 1李忆 1胡志敏 1张雨 1邱嘉欣 1韩乐 1谢海玉2
作者信息
- 1. 赣南医科大学第一临床医学院
- 2. 赣南医科大学第一附属医院麻醉手术中心 赣州市麻醉学重点实验室赣南医科大学第一临床医学院麻醉学教研室,江西 赣州 341000
- 折叠
摘要
保留自主呼吸的全身麻醉方式是指在外科手术中,采用非气管插管保留患者自主呼吸,术中使用不侵入气管的气道装置,同时辅以区域麻醉、静脉镇静镇痛药物的一种麻醉方式.随着电视胸腔镜手术(Video-assisted thoracoscopic surgery,VATS)的发展,支气管内插管全身麻醉已成为胸外科手术的常规麻醉方法.随着加速康复外科(Enhanced recovery after surgery,ERAS)理念和个性化医疗的普及,人们重新关注保留自主呼吸的非插管全身麻醉,以减少支气管插管可能带来的不良影响.本综述结合近年来的研究,评估了这一麻醉方式在胸科手术中的应用,重点探讨了其技术原理、临床效果、安全性及应用前景.文献结果表明,保留自主呼吸的全身麻醉在特定手术中的临床应用显示出较好的安全性和效果,有助于加速患者术后恢复.未来的研究将进一步明确其适应证和长远效果,不断改良优化,推动其在胸外科手术中的合理应用.
Abstract
The technique of general anesthesia with preserved spontaneous respiration refers to a method of anesthesia in which,during surgical procedures,the patient's spontaneous respiration is maintained without tracheal intubation.Instead,non-invasive airway devices are used,in combination with regional anesthesia and intravenous sedation-analgesia.With the development of video-assisted thoracoscopic surgery(VATS),tracheal intubation general anesthesia has become a common approach for thoracic surgery.However,as the concepts of Enhanced Recovery After Surgery(ERAS)and personalized medicine have gained popularity,attention has been refocused on non-intubated general anesthesia with preserved spontaneous respiration to mitigate the potential adverse effects of tracheal intubation.This review summarizes recent research on the application of this anesthesia technique in thoracic surgery,with a particular focus on its technical principles,clinical outcomes,safety,and future prospects.Literature findings indicate that general anesthesia with preserved spontaneous respiration has demonstrated favorable safety and efficacy in specific surgical contexts,contributing to accelerated postoperative recovery.Future research will aim to further clarify its indications,long-term outcomes and continual refinement,promoting its rational application in thoracic surgery.
关键词
保留自主呼吸/通气方式/神经阻滞/电视胸腔镜手术Key words
Preservation of spontaneous breathing/Mode of ventilation/Nerve block/Video-assisted thoracoscopic surgery引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据