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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Patient selection in ambulatory anesthesia - An evidence-based review: part I: (La selection des patients en anesthesie ambulatoire - Une revue factuelle : partie I).
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Patient selection in ambulatory anesthesia - An evidence-based review: part I: (La selection des patients en anesthesie ambulatoire - Une revue factuelle : partie I).

机译：动态麻醉中的患者选择-循证审查：第一部分：（动态麻醉中患者的选择-循证审查：第一部分）。

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PURPOSE: To identify and characterize the evidence supporting decisions made in the care of patients with selected medical conditions undergoing ambulatory anesthesia and surgery. Conditions highlighted in this review include: the elderly, heart transplantation, hyper-reactive airway disease, coronary artery disease, and obstructive sleep apnea. SOURCE: A structured search of MEDLINE (1966-2003) was performed using keywords for ambulatory surgery and patient condition. Selected articles were assigned a level of evidence using Centre for Evidence Based Medicine (CEBM) criteria. Recommendations were also graded using CEBM criteria. PRINCIPAL FINDINGS: The elderly may safely undergo ambulatory surgery but are at increased risk for hemodynamic variation in the operating room. The heart transplant recipient is at increased risk of coronary artery disease and renal insufficiency and should undergo careful preoperative evaluation. The patient with reactive airway disease is at increased risk of minor respiratory complications and should be encouraged to quit smoking. The patient with coronary artery disease and recent myocardial infarction may undergo ambulatory surgery without stress testing if functional capacity is adequate. The patient with obstructive sleep apnea is at increased risk of difficult tracheal intubation but the likelihood of airway obstruction and apnea following ambulatory surgery is unknown. CONCLUSION: Ambulatory anesthesia is infrequently associated with adverse outcomes, however, knowledge regarding specific patient conditions is of generally low quality. Few prospective trials are available to guide management decisions.
机译：目的：鉴定和表征支持选择动态卧床麻醉和手术的医疗条件患者的护理决定的证据。这篇综述强调的疾病包括：老年人，心脏移植，气道反应过度，冠状动脉疾病和阻塞性睡眠呼吸暂停。资料来源：使用门诊手术和患者状况的关键字对MEDLINE（1966-2003）进行了结构化搜索。使用循证医学中心（CEBM）的标准为选定的文章分配了一定程度的证据。还使用CEBM标准对建议进行了分级。主要发现：老年人可以安全地进行门诊手术，但手术室血液动力学变化的风险增加。心脏移植受者患冠状动脉疾病和肾功能不全的风险增加，应接受仔细的术前评估。患有反应性气道疾病的患者发生轻微呼吸系统并发症的风险增加，应鼓励其戒烟。如果功能能力足够，患有冠状动脉疾病和近期心肌梗塞的患者可进行门诊手术，而无需进行压力测试。阻塞性睡眠呼吸暂停的患者发生气管插管困难的风险增加，但动态手术后气道阻塞和呼吸暂停的可能性尚不清楚。结论：动态麻醉很少与不良结局相关，但是，有关特定患者状况的知识通常质量较低。很少有前瞻性试验可用于指导管理决策。

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