围手术期麻醉床旁监测技术的研究进展OA
Research progress and future perspectives on bedside anesthesia monitoring
围手术期患者安全依赖于实时、精准、个体化的床旁监测.传统单参数监测难以同步评估麻醉药物效应、器官灌注与机体内环境稳态.本文系统总结2023-2025年麻醉床旁监测领域关键技术进展,严格按照创新基础生命体征监测、器官靶向精准监测以及床旁内环境稳态评估三大核心维度分层梳理,重点阐述呼气末丙泊酚监测、扩展肺泡最低有效浓度(extended minimum alveolar concentration,eMAC)多模式麻醉深度监测、床旁超声联合血流动力学评估、可穿戴无创呼吸与代谢监测等突破性技术,批判性对比各类技术临床性能、循证证据层级、应用优势与临床局限性,弥补现有综述仅罗列设备、缺乏系统证据整合的短板.当前领域共性瓶颈包含技术操作标准化缺失、高质量多中心RCT证据不足、设备购置与运维成本效益失衡、临床指标解读主观性差异大等现实问题.未来发展路径聚焦多模态生理数据融合、可解释人工智能驱动风险预警、轻量化无线可穿戴监测设备、覆盖术前-术中-PACU-病房全程连续闭环监测四大方向.本文为精准麻醉落地、围手术期不良事件风险防控提供完整循证实施框架.
Perioperative patient safety relies on real-time,accurate,and individualized bedside monitor‑ing.Traditional single-parameter surveillance is limited in simultaneously evaluating anesthetic drug effects,organ perfusion,and internal homeostasis.This narrative review systematically summarizes key technological advances in bedside anesthesia monitoring from 2023 to 2025,structured into three core dimensions:innovative basic vital sign monitoring,organ-targeted precision monitoring and internal environment homeostasis assessment.We highlight breakthroughs including end-tidal propofol detection,extended minimum alveolar concentration(eMAC)multi‑modal depth of anesthesia monitoring,point-of-care ultrasound-integrated hemodynamic assessment,and wearable noninvasive respiratory and metabolic monitoring.Clinical performance,validation evidence grades,advantages,and limitations of each technology are critically compared to address the weakness of previous reviews that only enumerate devices without systematic evidence integration.Current shared bottlenecks include insufficient technical operation standardization,limited high-quality multicenter RCT evidence,unbalanced cost-utility of equipment purchase and maintenance,and large variability in clinical interpretation of monitoring indexes.Future development paths center on multimodal physiological data fusion,explainable artificial intelligence-driven early warning,light‑weight wireless wearable monitoring devices,and full closed-loop continuous monitoring covering preoperation-intraoperation-PACU-ward phases.This review provides an evidence-based framework for precision anesthesia prac‑tice and perioperative adverse event risk reduction.
黄江远;姚伟锋
中山大学附属第三医院麻醉科(广东 广州 510275)中山大学附属第三医院麻醉科(广东 广州 510275)
医药卫生
麻醉床旁监测呼气末丙泊酚床旁超声多模式监测围手术期患者安全
bedside anesthesia monitoringend-tidal propofolpoint-of-care ultrasoundmulti‑modal monitoringperioperative patient safety
《实用医学杂志》 2026 (17)
3127-3135,9
广东省基础与应用基础研究基金项目(编号:2024A1515220097)
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