可持续麻醉与环境管理：平衡生态责任与患者安全

文献信息

中文摘要

目的： 本叙述性综述旨在总结和评估可持续麻醉与患者安全方面的近期研究。

近期发现： 近期证据将挥发性麻醉药描述为全氟和多氟烷基物质，支持在临床适当时转向静脉麻醉。丙泊酚可能引起的生态毒性极小，全静脉麻醉技术安全有效。可重复使用的麻醉设备，如喉罩气道、呼吸回路和患者加温装置，可减少温室气体排放，并且在遵循适当消毒方案时不影响患者安全。虚拟术前麻醉咨询可减少温室气体排放，近期随机对照试验发现虚拟咨询与面对面咨询在麻醉评估准确性方面无差异。最后，随着极端天气事件频率和强度持续增加，我们强调麻醉中气候韧性系统的重要性。

总结： 可持续麻醉的新文献强调转向静脉麻醉、使用可重复使用设备（如患者加温装置）、虚拟术前麻醉咨询以及气候韧性的重要性。

英文摘要

PURPOSE OF REVIEW: This narrative review aims to summarize and assess recent research in sustainable anesthesia and patient safety.
RECENT FINDINGS: Recent evidence characterizing volatiles as per- and polyfluoroalkyl substances, supports transitioning towards intravenous anesthesia where clinically appropriate. Potential ecotoxicity caused by propofol is minimal, and total intravenous anesthetic techniques are safe and effective. Reusable anesthetic equipment, such as laryngeal mask airways, breathing circuits, and patient warming devices, reduces greenhouse gas emissions and does not impact patient safety when proper sanitation protocols are followed. Virtual preoperative anesthetic consultations reduce greenhouse gas emissions, and recent randomized controlled trials found no difference in the accuracy of anesthetic assessment between virtual and in-person consultations. Finally, as extreme weather events continue to increase in frequency and intensity, we highlight the importance of climate-resilient systems in anesthesia.
SUMMARY: New literature in sustainable anesthesia emphasizes the importance of transitioning to intravenous anesthesia, using reusable equipment such as patient warming devices, virtual preoperative anesthesia consultations, and climate resiliency.