泗水Soetomo博士综合学术医院气道手术的麻醉和镇痛管理概况

Agustina Salinding, Widiartha Wahyudi, Arya Pradipta
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引用次数: 1

摘要

耳鼻喉(ENT)手术是一种常见的手术,通常需要外科医生和麻醉师共用一个工作空间。多年来,耳鼻喉外科技术已经从传统方法发展到计算机辅助术中导航。与过去相比,微创入路鼻窦和岩骨手术现在是首选。出血、术后恶心和呕吐是耳鼻喉科手术常见的并发症。此外,手术过程中的疼痛管理和手术后患者的舒适度对麻醉师来说是一个挑战。因此,麻醉药物的选择很重要。目的:本研究旨在确定泗水Soetomo博士综合学术医院耳鼻喉外科的动作概况、麻醉管理和疼痛管理。材料与方法:本研究为回顾性描述性研究。共有177例患者接受了气道手术。数据来自Dr. Soetomo综合学术医院综合外科中心2021年1月至12月记录的医疗记录。结果与讨论:患者年龄以45 ~ 65岁居多(40.1%),男性居多(65.5%)。年龄≥20岁的患者营养状况正常(54.2%)。最常见的诊断是喉癌(23%),最常见的是微喉手术(35.8%)。大多数手术时间小于60分钟,其次为60 ~ 119分钟(27.1%)。最常用的诱导剂是异丙酚、芬太尼和罗库溴铵的组合(39.5%),最常用的吸入剂是异氟醚(91.3%)。甲胺唑(70.1%)是最常用的术后镇痛药。结论:麻醉诱导一般采用静脉用药。不同诱导剂的组合可带来协同效应。
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Anesthesia and Analgesia Management Profile for Airway Surgeries at Dr. Soetomo General Academic Hospital Surabaya
Introduction: Ear, Nose, and Throat (ENT) surgeries are commonly performed and very often require the surgeon and anesthesiologist to share the same workspace. Over the years, ENT surgery techniques have evolved from conventional methods to computer-assisted intraoperative navigation. In contrast to the past, a minimally invasive approach to paranasal sinus and petrous bone surgery is now preferred. Bleeding, postoperative nausea, and vomiting are complications often encountered in ENT surgery. In addition, pain management during surgery and patient comfort after a surgical procedure is a challenge for anesthesiologists. Therefore, the choice of anesthetic drugs is important. Objective: This study aims to determine the action profile, anesthetic management, and pain management in ENT surgery at Dr. Soetomo General Academic Hospital Surabaya. Materials and Methods: This is a retrospective descriptive study. A total of 177 patients underwent airway surgery. Data were obtained from the Medical Records of the Integrated Surgery Center of Dr. Soetomo General Academic Hospital recorded from January to December 2021. Results and Discussion: Most of the patients were in the age group of 45 - 65 years (40.1%) and a majority were men (65.5%). Most patients who were ≥ 20 years old had a normal nutritional status (54.2%). The most frequent diagnosis was laryngeal cancer (23%), with micro laryngeal surgery being the most frequently performed (35.8%). Most surgeries also needed less than 60 minutes followed by 60 to 119 minutes (27.1%). The most frequently used induction agents were a combination of propofol, fentanyl, and rocuronium (39.5%), with isoflurane as the most frequent inhalation agent (91.3%). Metamizole (70.1%) was the most postoperative analgesic. Conclusion: In general, intravenous agents were used for anesthesia induction. A combination of different induction agents brings synergistic benefits.
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