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頁籤選單縮合
題名 | 脊椎手術麻醉=Anesthesia for Spine Surgery |
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作 者 | 蔡玉娟; | 書刊名 | 麻醉學雜誌 |
卷期 | 37:4(增刊) 民88.12 |
頁次 | 頁S9-S17 |
分類號 | 416.5 |
關鍵詞 | 麻醉; 脊椎手術; 脊椎側彎; Anesthesia; Surgery; Spinal; Scoliosis; |
語文 | 中文(Chinese) |
中文摘要 | 脊椎手術在骨科的領域佔有重要之地位,其麻醉的品質關係病人手術的預後,對麻 醉醫師而言是一項挑戰。脊椎手術可以是常規手術,如脊推狹窄(spinal stenosis)或椎間盤突出 症(herniation of intervertebral disk)的手術;亦可以是急診手術,如因腫瘤轉移至脊椎造成神經 症狀或骨折的手術。麻醉計劃將因手術之急迫程度、適應症、病灶部位之高低及病人身體狀 況而有所不同。本文分別就腰椎、胸椎、頸椎及脊椎側彎(scoliosis)等手術之麻醉討論之。完 整的術前評估和麻醉計劃是很重要的,尤其是脊椎側彎手術麻醉需要照護與監測的層面更 廣,包括可能困難插管、改變姿勢時病人的保護、體溫的維持、麻醉中的監測、麻醉劑的選 擇、大量血液流失的處理、脊髓功能的監測(軀體感覺誘發電位或運動誘發電位),以及術後 疼痛控制,這些項目當然也適用於其它脊椎手術。 |
英文摘要 | Spine surgery is one of the important specialties in the field of orthopedics. The perioperative care of patients who receive spine surgery presents some challenges uniquely to anesthesiologists. Surgery of the spine can be elective as for spinal stenosis or disk herniation, urgent as for metastatic disease with the development of neurological deficit, or emergent as for spinal fracture. The anesthetic plan is decided by the degree of urgency, the indication for the surgery, the level of the spine involved in the surgical procedure and the physical status of patient. This review article is to address the anesthetic issues of the spine surgery including the lumbar, thoracic, cervical spine and scoliosis procedures, with special focus on the scoliosis pertaining to positioning, temperature support, anesthetic monitoring, selection of anesthetic agents, prevention and management of massive blood loss, spinal cord monitoring (somatosensory-evoked potentials and motor-evoked potentials), and postoperative pain control. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。