The evolution of thoracic anesthesia.
The evolution of thoracic anesthesia.
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DOI：
10.1016/j.thorsurg.2004.08.005
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发表时间：
2005-02-01
影响因子：
2.1
通讯作者：
Brodsky, Jay B
中科院分区：
文献类型：
--
作者：
Brodsky, Jay B
胸外科专业随着现代麻醉实践的发展而发展。这种密切的关系始于20世纪30年代，一直延续到今天。胸外科手术已经从一个几乎完全局限于简单胸壁手术的领域发展到现在的情况，复杂的手术，如肺减容或肺移植，现在可以在最严重的病人身上进行。胸外科的巨大进步是随着许多医学领域的发现和技术创新而来的。胸外科手术数量和复杂性迅速增加的最重要原因之一是胸外科手术麻醉的发展。在这一领域取得了如此大的进展，以至于许多书籍和期刊完全致力于这一主题。作者有幸与几位专门从事非心脏胸外科手术的外科医生合作。著名的肺外科医生詹姆斯·b·d·马克（James B.D. Mark）与他共事了25年，他写道：“任何手术都是团队合作的结果……（但）在胸外科手术中，团队的努力比任何地方都更重要，所有参与者的动作近乎编排是必不可少的。信息、状态和计划的交换是强制性的”。这种胸外科医生和麻醉师之间的团队合作方式反映了这两个专业的历史。随着技术的进步，如连续血气监测和肺循环的药理学管理，以最大限度地提高单肺通气期间的氧合，在未来，甚至更复杂的程序可能能够安全地对更高风险的患者进行。
The specialty of thoracic surgery has evolved along with the modem practice of anesthesia. This close relationship began in the 1930s and continues today. Thoracic surgery has grown from a field limited almost exclusively to simple chest wall procedures to the present situation in which complex procedures, such as lung volume reduction or lung transplantation, now can be performed on the most severely compromised patient. The great advances in thoracic surgery have followed discoveries and technical innovations in many medical fields. One of the most important reasons for the rapid escalation in the number and complexity of thoracic surgical procedures now being performed has been the evolution of anesthesia for thoracic surgery. There has been so much progress in this area that numerous books and journals are devoted entirely to this subject. The author has been privileged to work with several surgeons who specialized in noncardiac thoracic surgery. As a colleague of 25 years, the noted pulmonary surgeon James B.D. Mark wrote, "Any operation is a team effort... (but) nowhere is this team effort more important than in thoracic surgery, where near-choreography of moves by all participants is essential. Exchange of information, status and plans are mandatory". This team approach between the thoracic surgeon and the anesthesiologist reflects the history of the two specialties. With new advances in technology, such as continuous blood gas monitoring and the pharmacologic management of pulmonary circulation to maximize oxygenation during one-lung ventilation, in the future even more complex procedures may be able to be performed safely on even higher risk patients.