Planning for operating room efficiency and faster anesthesia wake-up time in open major upper abdominal surgery.
Planning for operating room efficiency and faster anesthesia wake-up time in open major upper abdominal surgery.
复制标题
DOI：
10.1097/md.0000000000006148
复制
发表时间：
2017-02
期刊：
影响因子：
1.6
通讯作者：
Wu ZF
中科院分区：
文献类型：
--
作者：
Lai HC;Chan SM;Lu CH;Wong CS;Cherng CH;Wu ZF
减少麻醉控制时间 (ACT) 可以提高不同麻醉技术导致的手术室 (OR) 效率。然而，文献中没有关于全身麻醉 (GA) 下开放性上腹部大手术中地氟烷 (DES) 麻醉和丙泊酚全静脉麻醉 (TIVA) 技术之间 ACT 差异的信息。本回顾性研究利用我院数据库，分析2010年1月至2011年12月，无肝切除的开腹上腹部大手术，采用地氟烷/芬太尼麻醉或芬太尼/异丙酚靶控输注TIVA后的ACT。各时间间隔包括等待麻醉时间、麻醉时间、手术时间、拔管时间、拔管后退出手术室、总手术室时间、比较这两种麻醉技术在麻醉后监护室 (PACU) 的停留时间和长时间拔管（≥15 分钟）的百分比。我们纳入了 343 名患者的数据，其中 159 名患者接受 TIVA，184 名患者接受 DES。唯一显着差异是拔管时间，TIVA 比 DES 组快（8.5±3.8 分钟 vs 9.4±3.7 分钟；P=0.04）。导致拔管时间延长的因素包括年龄、性别、体重指数、DES 麻醉和麻醉时间。在我院，采用基于异丙酚的靶控输注 TIVA 与 DES 麻醉相比苏醒更快；然而，它并没有提高开放式腹部大手术的手术效率。年龄较大、男性、较高的体重指数、DES 麻醉和较长的麻醉时间是影响拔管时间的因素。
Reducing anesthesia-controlled time (ACT) may improve operation room (OR) efficiency result from different anesthetic techniques. However, the information about the difference in ACT between desflurane (DES) anesthesia and propofol-based total intravenous anesthesia (TIVA) techniques for open major upper abdominal surgery under general anesthesia (GA) is not available in the literature. This retrospective study uses our hospital database to analyze the ACT of open major upper abdominal surgery without liver resection after either desflurane/fentanyl-based anesthesia or TIVA via target-controlled infusion with fentanyl/propofol from January 2010 to December 2011. The various time intervals including waiting for anesthesia time, anesthesia time, surgical time, extubation time, exit from OR after extubation, total OR time, and postanesthetic care unit (PACU) stay time and percentage of prolonged extubation (≥15 minutes) were compared between these 2 anesthetic techniques. We included data from 343 patients, with 159 patients receiving TIVA and 184 patients receiving DES. The only significant difference is extubation time, TIVA was faster than the DES group (8.5 ± 3.8 vs 9.4 ± 3.7 minutes; P = 0.04). The factors contributed to prolonged extubation were age, gender, body mass index, DES anesthesia, and anesthesia time. In our hospital, propofol-based TIVA by target-controlled infusion provides faster emergence compared with DES anesthesia; however, it did not improve OR efficiency in open major abdominal surgery. Older, male gender, higher body mass index, DES anesthesia, and lengthy anesthesia time were factors that contribute to extubation time.