Tu Zhenzhen,Xu Ying.Preoperative anesthesia evaluation for pediatric minimally invasive day surgery[J].Journal of Clinical Pediatric Surgery,2024,(10):906-909.[doi:10.3760/cma.j.cn101785-202407009-002]
儿童日间微创手术的麻醉前评估
- Title:
- Preoperative anesthesia evaluation for pediatric minimally invasive day surgery
- Keywords:
- Child; Day Surgery; Minimally Invasive; Pre-Anesthesia Assessment
- 摘要:
- 日间微创手术是日间手术的一种, 麻醉前评估是确保儿童日间微创手术得以顺利进行的关键。日间微创手术的麻醉前评估既不能脱离日间手术的麻醉前评估, 又不能完全等同于常规日间手术的麻醉前评估。正确认识这一类日间手术的麻醉前评估, 才能在纳入和排除标准上做到既不过"松", 也不过"严", 充分发挥日间微创手术"日间"和"微创"的特点。儿童日间微创手术具有创伤小、恢复快的优点, 但就微创手术的麻醉而言, 因患儿年龄小、气腹对生理指标的影响大、留院观察时间短, 导致手术麻醉的风险相对较高。本文旨在阐述儿童日间微创手术的麻醉前评估现状与发展、麻醉前评估时效性问题以及麻醉前评估内容的医学建议。
- Abstract:
- Minimally invasive day surgery is a category of day surgery, and preoperative anesthesia evaluation is a critical step in ensuring the smooth conduct of pediatric minimally invasive day surgery.The preoperative anesthesia evaluation for such surgeries should neither completely deviate from the standard evaluation protocols for day surgeries nor be considered entirely equivalent to them.Proper understanding of the specific requirements for preoperative anesthesia evaluation in this context ensures that inclusion and exclusion criteria are neither too lenient nor too strict, thereby fully leveraging the benefits of "daytime" and "minimally invasive" aspects of these surgeries.Pediatric minimally invasive day surgeries offer advantages such as minimal trauma and rapid recovery.However, the anesthetic management of these surgeries presents higher risks due to factors such as the young age of the patients, the significant physiological impact of pneumoperitoneum, and the brief postoperative observation period.This article discusses the current status and developments in preoperative anesthesia evaluation for pediatric minimally invasive day surgeries, issues regarding the timeliness of evaluations, and provides medical recommendations for the content of these evaluations.
参考文献/References:
[1] Horvath B, Kloesel B, Todd MM, et al.The evolution, current value, and future of the American Society of Anesthesiologists Physical status classification system[J].Anesthesiology, 2021, 135(5):904-919.DOI:10.1097/ALN.0000000000003947.
[2] Snow SJ.Blessed days of anaesthesia:how anaesthetics changed the world[M].New York:Oxford University Press, 2008:226.
[3] Gooden CK, Frost EAM.Preprocedural evaluation:considerations outside of the operating room[J].Curr Opin Anaesthesiol, 2015, 28(4):441-445.DOI:10.1097/ACO.0000000000000217.
[4] 陈菲, 王寿勇, 刘巍, 等.探讨儿童日间手术麻醉管理规范[J].重庆医学, 2018, 47(8):1130-1132.DOI:10.3969/j.issn.1671-8348.2018.08.040. Chen F, Wang SY, Liu W, et al.Exploring the management standards for anesthesia in children’s day surgery[J].Chongqing Med J, 2018, 47(8):1130-1132.DOI:10.3969/j.issn.1671-8348.2018.08.040.
[5] 中国心胸血管麻醉学会日间手术麻醉分会, 中华医学会麻醉分会小儿麻醉学组.小儿日间手术麻醉指南[J].中华医学杂志, 2019, 99(8):566-570.DOI:10.3760/cma.j.issn.0376-2491.2019.08.002. Day Surgery Anesthesia Branch of the Chinese Society of Cardiothoracic and Vascular Anesthesia, Pediatric Anesthesiology Group of the Anesthesiology Branch of the Chinese Medical Association.Guidelines for anesthesia in pediatric day surgery[J].Natl Med J China, 2019, 99(8):566-570.DOI:10.3760/cma.j.issn.0376-2491.2019.08.002.
[6] Section on Anesthesiology and Pain Medicine, Polaner DM, Ho-uck CS, et al.Critical elements for the pediatric perioperative anesthesia environment[J].Pediatrics, 2015, 136(6):1200-1205.DOI:10.1542/peds.2015-3595.
[7] Kurth CD, Coté CJ.Postoperative apnea in former preterm infants:general anesthesia or spinal anesthesia-Do we have an answer?[J].Anesthesiology, 2015, 123(1):15-17.DOI:10.1097/ALN.0000000000000710.
[8] McHoney M, Corizia L, Eaton S, et al.Carbon dioxide elimination during laparoscopy in children is age dependent[J].J Pediatr Surg, 2003, 38(1):105-110.DOI:10.1053/jpsu.2003.50021.
[9] Uffman JC, Kim SS, Quan LN, et al.Adverse events in infants less than 6 months of age after ambulatory surgery and diagnostic imaging requiring anesthesia[J].Pediatr Qual Saf, 2022, 7(4):e574.DOI:10.1097/pq9.0000000000000574.
[10] Tait AR, Malviya S.Anesthesia for the child with an upper respiratory tract infection:Still a dilemma?[J].Anesth Analg, 2005, 100(1):59-65.DOI:10.1213/01.ANE.0000139653.53618.91.
[11] Nasr VG, Markham LW, Clay M, et al.Perioperative considerations for pediatric patients with congenital heart disease presenting for noncardiac procedures:a scientific statement from the American Heart Association[J].Circ Cardiovasc Qual Outcomes, 2023, 16(1):e000113.DOI:10.1161/HCQ.0000000000000113.
[12] Yamamoto T, Schindler E.Anaesthesia management for non-cardiac surgery in children with congenital heart disease[J].Anaesthesiol Intensive Ther, 2016, 48(5):305-313.DOI:10.5603/AIT.a2016.0050.
相似文献/References:
[1]杜朝峻,丁力,胡英超,等.手术治疗婴幼儿法洛四联症83例[J].临床小儿外科杂志,2010,9(06):413.
DU Chao jun,DING Li,HU Ying chao,et al.Surgical treatment of Tetralogy of Fallot in infancy: Experiences of 83 cases.[J].Journal of Clinical Pediatric Surgery,2010,9(10):413.
[2]常绘文,沈振亚.右腋下小切口在儿童心内手术中的应用[J].临床小儿外科杂志,2010,9(06):439.
[3]王勇,汤绍涛,毛永忠,等.腔镜下手术治疗小儿膈肌疾病31例[J].临床小儿外科杂志,2010,9(06):441.
[4]欧阳帆,张治明,曾宾,等.七氟醚复合髂腹股沟-髂腹下神经阻滞用于小儿腹股沟手术[J].临床小儿外科杂志,2010,9(06):466.
[5]徐华,赵陶丽.瑞芬太尼对小儿等离子刀扁桃体腺样体切除术应激反应的影响[J].临床小儿外科杂志,2010,9(06):468.
[6]周辉霞孙宁马立飞孟浩谢华伟申州陶天周晓光黄澄如李宏召张旭.腹腔镜下重复肾半肾切除术手术路径探讨[J].临床小儿外科杂志,2011,10(01):0.
ZHOU Hui xia,SU Ning,MA Li fei,et al.Which laparoscopic surgery approach is better for a nonfunctioning moiety in a duplex kidney in infants and children[J].Journal of Clinical Pediatric Surgery,2011,10(10):0.
[7]蒋欣李箭刘利君彭明惺唐学阳.儿童单纯性膝关节骨软骨骨折的关节镜治疗[J].临床小儿外科杂志,2011,10(01):0.
JIANG Xin,LI Jian,LIU Li jun,et al.Arthroscopic therapy of osteochondral fractures of the Knee in children.[J].Journal of Clinical Pediatric Surgery,2011,10(10):0.
[8]王伟程少文彭磊林忠勤张伟陈庆玉寇冬权.弹性髓内钉在儿童肱骨骨折中的应用[J].临床小儿外科杂志,2011,10(01):0.
WANG Wei,CHENG Shaowen,PENG Lei,et al.Application of elastic intramedullary nailing in pediatric humeral fractures.[J].Journal of Clinical Pediatric Surgery,2011,10(10):0.
[9]寿铁军李勇马能强龚晟.腹腔镜手术治疗小儿腹股沟斜疝1582例[J].临床小儿外科杂志,2011,10(01):0.
[10]吴臻斐陈聪德林进汉刘平李仲荣陈肖鸣.小儿急性肠套叠肠坏死相关因素分析[J].临床小儿外科杂志,2011,10(01):0.
[11]杜真,向珍,危思维,等.右美托咪定提高儿童日间手术舒适度的临床研究[J].临床小儿外科杂志,2020,19(07):622.[doi:10.3969/j.issn.1671-6353.2020.07.012]
Du Zhen,Xiang Zhen,Wei Siwei,et al.Clinical study of dexmedetomidine in enhancing perioperative comfort during daytime pediatric surgery[J].Journal of Clinical Pediatric Surgery,2020,19(10):622.[doi:10.3969/j.issn.1671-6353.2020.07.012]
[12]卞红强.日间手术初心与实践思考[J].临床小儿外科杂志,2024,(10):901.[doi:10.3760/cma.j.cn101785-202407002-001]
Bian Hongqiang.Reflections on original intent and practical issues of day surgery[J].Journal of Clinical Pediatric Surgery,2024,(10):901.[doi:10.3760/cma.j.cn101785-202407002-001]
[13]李本红,任宗艳,汤文香,等.儿童日间手术离院评分量表的编制及应用[J].临床小儿外科杂志,2024,(10):918.[doi:10.3760/cma.j.cn101785-202406067-004]
Li Benhong,Ren Zongyan,Tang Wenxiang,et al.Development and application of a discharge scoring scale for pediatric day surgery[J].Journal of Clinical Pediatric Surgery,2024,(10):918.[doi:10.3760/cma.j.cn101785-202406067-004]
[14]赵杭燕,刘喜旺,应力阳,等.日间手术管理模式在儿童机器人动脉导管结扎术中的应用[J].临床小儿外科杂志,2024,(10):924.[doi:10.3760/cma.j.cn101785-202402013-005]
Zhao Hangyan,Liu Xiwang,Ying Liyang,et al.Application of Enhanced Recovery Surgery in Pediatric Robotic Arteriosus Catheter Ligation Day Surgery[J].Journal of Clinical Pediatric Surgery,2024,(10):924.[doi:10.3760/cma.j.cn101785-202402013-005]
[15]徐瑞,邓志梅,陈进军.梭形日间管理模式下儿童腺样体切除术日间手术的全流程质量管理[J].临床小儿外科杂志,2024,(10):929.[doi:10.3760/cma.j.cn101785-202407012-006]
Xu Rui,Deng Zhimei,Chen Jinjun.Full process quality management of pediatric adenoidectomy day surgery under the "shuttle day management model"[J].Journal of Clinical Pediatric Surgery,2024,(10):929.[doi:10.3760/cma.j.cn101785-202407012-006]
备注/Memo
收稿日期:2024-7-5。
基金项目:国家儿童健康与疾病临床医学研究中心基金(NCRCCHD-2022-GP-14)
通讯作者:徐颖,Email:xuyingxy3066@126.com