歲月麻醉

Anesthesia,Joyful Life

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Enhance recovery after surgery (volume therapy)

大會演講的一個題目:


大綱:



  1. Tranditional fluid loading concept (評論傳統圍術期液體給予的觀念修正,到底水分要給多一點還是少一點?又是一個風向球!比較明確的有兩點,More flexible fasting principle不那麼嚴格的術前水分禁絕, No need for bowel preparation不需灌腸 )
  2. Complications from inappropriate peri-op fluid management (照本宣科,沒有什麼surprise!)
  3. Measurement of volume responsiveness(沒有提到,可能是牽涉的內容太過龐雜,臨時刪除了!)
  4. Fluid shift (Fluid shft的觀念,一般作麻醉的人大概都會有這樣的經驗,身體的fluid,甚至是intravascular vulume,都會隨著不同的姿勢或麻醉,流會心臟的量會變多或變少,重點在於這樣的水分或容量移動對病人是良性不予理會,還是惡性,有不良的影響?這也牽涉到第3個標題,如何監測的問題,以及要補volume還是要用vasopressor?)
  5. Colloid vs crystalloid ( 這是一個沒有解決的爭議,但通篇好像是在作藥物產品推廣活動,並沒有將學術的關鍵點提出來。)

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