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| 吸入麻醉临床实践中国专家共识（2024版）：一项基于Delphi法的研究 |
| Consensus statements of Chinese specialists on inhalation anesthesia （2024）: a Delphi method study |
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| DOI：10.12089/jca.2025.03.018 |
| 中文关键词: 吸入麻醉 患者安全 Delphi法 卫生健康可持续发展 |
| 英文关键词: Inhalation anesthesia Patient safety Delphi technique Health sustainability |
| 基金项目: |
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| 中文摘要: |
目的： 本研究旨在更新吸入麻醉临床实践的专家共识，为改善患者临床体验提供循证医学证据。
方法：本共识遵循《医疗保健实践指南报告项目声明（RIGHT）》制定。共识小组由证据组、专家组和秘书组构成。共识涉及的领域和主题经秘书组进行广泛临床调研，并经专家组协商后达成一致。经过系统文献回顾，GRADE法证据分级，两轮Delphi法，达到预设阈值（超过80%）者最终形成推荐意见。
结果：全国范围内本领域26位权威专家受邀加入专家组，其中15位至少参加了一轮的Delphi法投票。围绕三个领域中的12个主题达成了29项推荐意见。就围术期神经认知功能障碍、心脏不良事件、术后肺部并发症和急性肾功能障碍的风险相关吸入麻醉方案达成了共识。对吸入麻醉的准备、诱导、维持和洗脱策略的相关推荐意见，一致率由一轮Delphi的82.4%提高至100%。预防围术期神经认知功能障碍、术后恶心呕吐和恶性高热的共识意见的推荐率超过82.4%。
结论： 本研究为基于循证医学构建的吸入麻醉临床实践的全国专家共识更新。推荐意见将有助于在更佳替代方案出现前，促进吸入麻醉临床实践，有益于患者围术期安全及环境可持续发展。 |
| 英文摘要: |
Objective: This study aimed to update the expert consensus on the clinical practice of inhalation anesthesia and improve patient outcomes adherence to evidence-based medicine.
Methods: This consensus was developed in accordance with the Reporting Items for Practice Guidelines in Healthcare（RIGHT）. The consensus panel included an evidence panel， an expert panel， and a secretarial panel. The domains and topics were determined through extensive clinical questionnaire survey by the secretarial panel and consultation with the expert panel. Recommendations were reached after a systematic literature review， evidence grading using the GRADE system， and two rounds of Delphi， with consensus defined as agreement by more than 80% of participants.
Results: Twenty-six leading experts nationwide were invited to join the expert panel， with 15 participating in at least one round of Delphi method. A total of 29 recommendations were reached across 12 topics in three domains. Consensus was achieved on developing inhalation anesthesia relative protocols based on the risks of perioperative neurocognitive disorders， major adverse cardiac events， postoperative pulmonary complications， and acute kidney dysfunction. Agreement on strategies for preparation， induction， maintenance， and washout of inhalation anesthesia improved from 82.4% to 100%. More than 82.4% of experts agreed on statements related to the prevention of perioperative neurocognitive disorders， postoperative nausea and vomiting， and malignant hyperthermia.
Conclusion: A nationwide expert panel has reached consensus on the clinical practices of inhalation anesthesia， providing guidance based on scientific methodology. These recommendations are expected to improve patient outcomes and enhance environmental sustainability until a suitable alternative is validated． |
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