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首页> 外文期刊>Current opinion in anaesthesiology >Perioperative management of patients with alcohol, tobacco and drug dependency.
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Perioperative management of patients with alcohol, tobacco and drug dependency.

机译：酒精，烟草和药物依赖患者的围手术期管理。

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PURPOSE OF REVIEW: One in five patients in the perioperative setting has a alcohol use disorder (AUD), one in three patients has a nicotine use disorder (NUD) and one in 10 patients has a drug use disorder (DUD) with a high risk of dependency. Patients with dependencies challenge physicians with various complications within the perioperative setting. RECENT FINDINGS: Adequate treatment of alcohol, nicotine and drug dependency during the perioperative and intraoperative course requires established screening tools in order to evaluate patients' susceptibility to developing complications. Particularly in these patients, secondary prevention and early treatment is warranted. SUMMARY: Alcohol, nicotine and drug dependency are very treatable. Numerous effective therapeutic options are available and should be offered to patients. Intensive care treatment can be shortened or even avoided by initiating preventive measures. A multimodal approach includes implementation of screening tools, motivational interviewing, preoperative abstinence, individual anaesthesiological treatment, stress reduction preventing delirium and postoperative infection, prevention and treatment of withdrawal syndrome, replacement therapies and provision of preoperative or postoperative detoxification. The implementation rate is very low and urgently requires strategies for improvement.
机译：审查目的：围手术期患者中有五分之一患有酒精使用障碍（AUD），三分之一的患者患有尼古丁使用障碍（NUD），十分之一的患者患有高风险的药物使用障碍（DUD）的依赖。有依赖性的患者在围手术期中会向医生提出各种并发症。最近的发现：围手术期和术中过程中酒精，尼古丁和药物依赖性的充分治疗需要成熟的筛查工具，以评估患者发生并发症的易感性。特别是在这些患者中，有必要进行二级预防和早期治疗。总结：酒精，尼古丁和药物依赖性非常好。有许多有效的治疗选择，应该提供给患者。通过采取预防措施，可以缩短甚至避免重症监护治疗。一种多模式方法包括实施筛查工具，动机访谈，术前禁欲，个体麻醉治疗，预防stress妄和术后感染的压力减轻，戒断综合征的预防和治疗，替代疗法以及术前或术后排毒。实施率很低，迫切需要改进策略。

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