高风险麻醉过程中神经并发症的关键评估。

Journal of surgery and research Pub Date : 2024-01-01 Epub Date: 2024-06-06
Fihr Chaudhary, Zubair Ahmed, Devendra K Agrawal
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引用次数: 0

摘要

外周和中枢神经系统的损伤往往是不可逆的。手术引起的神经损伤和麻醉可能会给患者及其家属带来灾难性的后果。本文将探讨围手术期重大神经系统并发症的发生率。与肾脏、心脏、肝脏、肺脏和骨骼系统等其他器官相比,神经系统的原生功能不能很快被人工部件或设备取代。尽管中枢和外周神经系统至关重要,但在围手术期忽视大脑功能一直是麻醉学的一个系统性问题。这一大胆的说法旨在提请人们注意,与几十年来一直受到常规监测的循环和呼吸系统不同,大脑和其他神经结构在手术和麻醉期间并没有标准的监测。鉴于大脑和脊髓是镇痛剂和麻醉剂的主要治疗目标,临床护理中的这一缺陷就更加令人担忧了。众所周知,器官受损后很难修复或更换,但到目前为止,这些器官受到的关注却相对较少。本文简要概述了与手术和麻醉相关的五种神经系统并发症。在对相关文献进行批判性回顾后,文章将重点放在神经外科手术中常见的(谵妄)、有争议的(术后认知能力下降)和潜在的灾难性(中风、脊髓缺血或术后视力丧失)不良事件上。研究结果将提高手术和麻醉团队对主要神经系统并发症的认识,并加强围手术期的预防和治疗策略。
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Critical Assessment of the Neurological Complications during High-Risk Anesthesia Procedures.

Damage to the peripheral and central nervous systems is frequently irreversible. Surgically induced neurological damage and anesthesia may result in catastrophic situations for patients and their families. The incidence of significant neurological complications during the perioperative period is examined in this article. In contrast to other organs like the kidney, heart, liver, lungs, and skeletal system, native neurological function cannot be replaced with artificial parts or devices soon. Ignoring brain function during the perioperative period has been a systemic problem in anesthesiology, even though the central and peripheral nervous systems are crucial. This bold claim is intended to draw attention to the fact that, unlike the circulatory and respiratory systems, which have been routinely monitored for decades, the brain and other neural structures do not have a standard monitoring during surgery and anesthesia. Given that the brain and spinal cord are the principal therapeutic targets of analgesics and anesthetics, this deficiency in clinical care is even more alarming. Organs that are notoriously hard to repair or replace after damage have, up until now, received comparatively little attention. In this article, a succinct overview of five neurological complications associated with surgery and anesthesia is presented. After critically reviewing the literature on the subject, the article is focused to common (delirium), controversial (postoperative cognitive decline), and potentially catastrophic (stroke, spinal cord ischemia, or postoperative visual loss) adverse events in the neurological surgery setting. The findings will increase awareness of major neurological complications to the involved surgical and anesthesia team and enhance preventive and treatment strategies during the perioperative period.

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