手术室外麻醉11878例分析

【目的】对我院开展手术室外麻醉5年来的病例进行回顾性分析，旨在探讨院内进一步开展手术室外麻醉的安全性与可行性。【方法】应用全凭静脉麻醉在门诊内窥镜室开展无痛苦胃肠镜检查，以及与产科联合开展的无痛宫腔内诊疗；应用腰麻-硬膜外联合镇痛（Combined Spinal Epidural Analgesia，CSEA）与自控硬膜外镇痛（Patient Controlled Epidural Analgesia，PCEA）技术为产妇实施无痛分娩。【结果】5年来，共实施手术室外麻醉11878例。在手术室外实施全凭静脉麻醉共11381例，并发症或意外的发生率仅为1．58‰（18例）；在妇产科实施无痛分娩497例，其中自然分娩成功率为94．80％（471／497）。另外，无痛苦胃肠镜及宫腔内诊疗量占年总就诊量的比值逐年上升；总诊疗量5年来也呈现递增现象。【结论】我院开展的四项手术室外麻醉安全、可行，该研究为进一步开展手术室外麻醉提供了有利的临床依据。

Development of non-operating room anesthesia in our hospital

Objective] To assess the cttrrent non-operating room anesthesia in our hospital from 2003 to 2007. Methods] To date, we have performed gastrointestinal endoscopy in outpatient clinic under total intravenous anesthesia （TIVA） in place of endoscope. Outpatient received an intravenous pmpofol （ 1 - 1.5 mg/kg） . At obstetrical department, pregnant women who requested analgesia in early labor or induced abortion received combined spinal epidural analgesia at L2 - 3 or intravenous pmpofol （ 11.5 mg/kg） and fentanyl 0.05 mg. Results] Total intravenous analgesia was conducted on 11 381 patients during 5-year period from 2003 to 2007. Postoperative complications were rare, which occurred only 18 in 11 381 patients receiving TIVA. 497 pregnant women received labor analgesia during the same period. The success rate of labor analgesia was 94.80%. The ratio of receiving anesthetic patients to total patients increased gradually since 2003. Meanwhile, the number of total patients of receiving gastrointestinal endoscopy and induced abortion increased progressively during the recewt 5-years. Conclusions] The non-operating room anesthesia conducted is safe and feasible.