Shetti Akshaya N, Karigar Shivanand L, Mustilwar Rachita G, Singh D Roshan, Nag Kusha
Department of Anaesthesiology and Critical Care, Rural Medical College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India.
Department of Anesthesiology, BLDE University and Research Centre, Bijapur, Karnataka, India.
Anesth Essays Res. 2017 Oct-Dec;11(4):811-815. doi: 10.4103/0259-1162.186866.
It is not uncommon to see in developing and underdeveloped countries, where the anesthesiologist who is untrained in cardiac specialty takes care of cardiac catheterization centers. The service in cardiac catheterization laboratories (CCL) in developed countries and some of the developing countries is mainly provided by the cardiac anesthesiologists. The scenario is not same in some part of developing countries or in underdeveloped countries which are mainly due to increase in number of CCL (catheterization laboratory) when compared to the number of cardiac anesthesiologists working outside the operation theater. It is also important for training the postgraduate in this field as to make them capable and competitive in managing such cases during emergency situation as it may save the life of a patient. Many a times, CCL is built as per the need of cardiologist ignoring the basic needs of cardiac anesthesiologist. It is important to note that anesthesiologist should be competent enough to provide complete, integrated anesthetic care outside the operation theater with available resources. It is challenging for the anesthesiologist to provide sedation or general anesthesia in such critical area where he/she will be dealing with life-threatening situations. In the modern era, the interventional techniques are advancing and treating complex heart diseases is more often. Days are not far where the CCL procedures may reduce the requirement of major surgeries. A careful and dedicated approach by the anesthesiologist with thorough knowledge and skills decreases morbidity and mortality rate. This article helps both cardiac and noncardiac anesthesiologists to improve their knowledge and to approach the patient systematically.
在发展中国家和不发达国家,由未接受过心脏专科培训的麻醉医生负责心脏导管插入术中心的情况并不少见。在发达国家和一些发展中国家,心脏导管插入术实验室(CCL)的服务主要由心脏麻醉医生提供。而在一些发展中国家的部分地区或不发达国家,情况则有所不同,这主要是因为与手术室之外工作的心脏麻醉医生数量相比,CCL(导管插入术实验室)的数量有所增加。对该领域的研究生进行培训也很重要,以便他们在紧急情况下有能力且有竞争力地处理此类病例,因为这可能挽救患者的生命。很多时候,CCL是根据心脏病专家的需求建立的,而忽视了心脏麻醉医生的基本需求。需要注意的是,麻醉医生应具备足够的能力,利用现有资源在手术室之外提供全面、综合的麻醉护理。在这样一个他/她将应对危及生命情况的关键区域,麻醉医生提供镇静或全身麻醉具有挑战性。在现代,介入技术不断进步,治疗复杂心脏病的情况越来越常见。距离CCL手术可能减少大型手术需求的日子不远了。麻醉医生谨慎且专注的方法,加上全面的知识和技能,可降低发病率和死亡率。本文有助于心脏麻醉医生和非心脏麻醉医生提高他们的知识水平,并系统地处理患者。