最近6年間(1987年-1992年)の奈良県立医科大学麻酔科管理症例における緊急手術の推移

Abstract

Emergency operations from 1987 to 1992 in N ara Medical University Hospital were analyzed. Annual total numbers of anesthetized patients were 2811 cases in 1987, 2843 cases in 1988, 2938 cases in 1989, 3154 cases in 1990, 3243 cases in 1991, and 3295 cases in 1992 respectively, in which annual numbers of emergency operations were 357 cases in 1987, 361 cases in 1988, 370 cases in 1989, 492 cases in 1990, 509 cases in 1991, and 513 cases in 1992. They were promptly increased after the establishment of the Department (Dpt.) of Emergency and Critical Care Medicine in 1990. The most frequent performed operations as emergency surgery were as follows : Caesarean section and ectopic pregnancy in Dpt. of Obstetrics and Gynecology ; appenditis and peritonitis in Dpt. of 1st Surgery ; hydrocephalus, intracerebral hematoma, and cerebral aneurysm in Dpt. of 2nd Surgery ; aortic aneurysm and pneumothorax in Dpt. of 3rd Surgery ; appenditis, peritionitis, subdural hematoma, intracerebral hematoma, and cerebral aneurysm in Dpt. of Emergency and Critical Care Medicine. On the initiation time of surgery, 38.9% of emergency cases were started between 12 noon and 4p.m.. Average anesthetic times were as follows : 316 min (Dpt. of 3rd Surgery), 250 min (Orthopedics), 241 min (Critical Care Medicine) and 237 min (2nd Surgery). Whenever surgeons propose an emergency case, anesthesiologist should not cancel their requirement for morbid patient care. Hence it should be defined the reasonable decision (indication, initiation time etc.), and rules for perforning emergency operation, such as adequate numbers of operation rooms with surgeons, anethesiologists, nurses, and paramedical staffs.