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Expert consensus on difficult airway assessment 被引量:2
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作者 Ming Xia Wuhua Ma +19 位作者 Mingzhang Zuo Xiaoming Deng Fushan Xue Denise Battaglini Vivek Aggarwal Giustino Varrassi Vladimir Cerny Ida Di Giacinto Rita Cataldo Daqing Ma Toru Yamamoto Martina Rekatsina Alessandro De Cassai Andrea Carsetti Marvin G.Chang Edwin Seet Daniel P.Davis Michael G.Irwin Yuguang Huang Hong Jiang 《Hepatobiliary Surgery and Nutrition》 SCIE 2023年第4期545-566,共22页
Background:Identifying a potentially difficult airway is crucial both in anaesthesia in the operating room(OR)and non-operation room sites.There are no guidelines or expert consensus focused on the assessment of the d... Background:Identifying a potentially difficult airway is crucial both in anaesthesia in the operating room(OR)and non-operation room sites.There are no guidelines or expert consensus focused on the assessment of the difficult airway before,so this expert consensus is developed to provide guidance for airway assessment,making this process more standardized and accurate to reduce airway-related complications and improve safety.Methods:Seven members from the Airway Management Group of the Chinese Society of Anaesthesiology(CSA)met to discuss the first draft and then this was sent to 15 international experts for review,comment,and approval.The Grading of Recommendations,Assessment,Development and Evaluation(GRADE)is used to determine the level of evidence and grade the strength of recommendations.The recommendations were revised through a three-round Delphi survey from experts.Results:This expert consensus provides a comprehensive approach to airway assessment based on the medical history,physical examination,comprehensive scores,imaging,and new developments including transnasal endoscopy,virtual laryngoscopy,and 3D printing.In addition,this consensus also reviews some new technologies currently under development such as prediction from facial images and voice information with the aim of proposing new research directions for the assessment of difficult airway.Conclusions:This consensus applies to anesthesiologists,critical care,and emergency physicians refining the preoperative airway assessment and preparing an appropriate intubation strategy for patients with a potentially difficult airway. 展开更多
关键词 Expert consensus difficult airway airway management
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下肢截肢术后持续周围神经阻滞的作用:对幻肢综合征症状的影响 被引量:1
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作者 Battista Borghi, MD Marco D'Addabbo, MD +8 位作者 Paul F. White, MD, PhD Pina Gallerani,RN Letizia Toccaceli, ND William Raffaeli, MD Andrea Tognu, MD Nicola Fabbri, MD and Mario Mercuri, MD 毛祖旻(译) 李士通(校) 《麻醉与镇痛》 2012年第3期44-51,共8页
背景达90%的截肢者在肢体截肢术后会产生幻肢综合征(phantom limb syndroms,PLS)。尽管现在有很多不同的治疗方法,但没有一种是显著有效的。因此,我们评估了高浓度的局麻药在外周神经的持续输注对预防PLS的效果。方法在术前或术中... 背景达90%的截肢者在肢体截肢术后会产生幻肢综合征(phantom limb syndroms,PLS)。尽管现在有很多不同的治疗方法,但没有一种是显著有效的。因此,我们评估了高浓度的局麻药在外周神经的持续输注对预防PLS的效果。方法在术前或术中给71例行下肢截肢术的患者放置一周围神经导管,通过弹力输注泵(非电子)在术中开始以5ml/h的速率持续输注0.5%罗哌卡因,并且持续到术后的第4—83天。在术后的第1天,第1、2、3、4周和第3、6、9、12月评估PLS。为了评估患者在接受罗哌卡因输注时PLS是否存在及其严重程度,在每次评估前中断6—12小时的给药(即直至肢体感觉的恢复)。幻肢痛和残肢痛的程度由5分级的VRS评分系统来评分,其中0分代表无疼痛,4分代表不能忍受的疼痛,而幻肢的感觉被记录为存在或者不存在。如果VRS评分大干1分或者有显著的幻肢感觉出现,罗哌卡因立即以5ml/h的速率重新开始输注。如果患者的VRS评分持续为0或1分并且无幻肢感觉达48小时,则输注完全停止并移除导管。结果局麻药的持续输注时间的中位数是30天(95%的可信区间,25-30天)。在术后第1天,73%的患者主诉有严重的或者不能忍受的疼痛(VRS评分大于2分)。但是,在12个月的评估期的最后患者“严重到不能忍受”的幻肢痛的发生率仅为3%。在第12个月末,患者VRS疼痛评分的百分比:84%的患者为0分,10%的患者为1分,3%的患者为2分,3%的患者为3分,没有患者为4分。但是,在12个月的评估期的最后仍有39%的患者有幻肢感觉。所有患者都能在家中应用这种弹力输注系统。结论术后予以0.5%的罗哌卡因于神经周的持续输注可能是下肢截肢术后治疗幻肢痛和幻肢感觉的有效方法。 展开更多
关键词 周围神经阻滞 下肢截肢术 截肢术后 幻肢痛 综合征 周围神经导管 持续输注 评分系统
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