Driving performance of outpatients achieving discharge criteria after deep sedation is worse than these of their escort-driver: a prospective observational study on simulator.

IF 1.3 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY
F J Lois, Q Massart, D O Warner, C Malengreaux, M Knops, A S Nyssen, J F Brichant, C O Hallet
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引用次数: 1

Abstract

Background: Achieving post-anesthesia discharge criteria after surgery or outpatient procedures does not mean that the patient has regained all his or her faculties, such as driving. Although mandated by many clinical guidelines, there is no evidence that escort-drivers reduce the risk of traffic accidents after deep sedation. The purpose of this study was to evaluate that hypothesis that driving performance as measured using a driving simulation would not differ between patients who had undergone deep sedation for gastrointestinal endoscopy meeting discharge criteria and their escorts.

Methods: This prospective study included patients scheduled for ambulatory gastrointestinal endoscopy under deep propofol sedation (patient group) and their escorts (escort group). Driving performance of escorts and patients (when discharge criteria were met) was assessed using a driving simulator.

Results: 30 patients and their escorts were included. Patients crossed the midline significantly more frequently than escorts (3 [2-4] (median [IQR]) and 2 [1-3] crossings, respectively, p=0.015]. Patients were speeding for a higher proportion of the distance traveled compared with escorts (37 (20)% (mean (SD)) and 24 (17)% in patients and escorts, respectively, p = 0.029). There were no significant differences between groups in other simulation parameters.

Conclusions: The ability to stay within the traffic lanes, as measured by the number of midline crossing during a simulated driving performance, is impaired in patients who meet discharge criteria after gastrointestinal endoscopy under deep sedation compared with their escorts. This finding does not support a practice of allowing patients to drive themselves home after these procedures.

深度镇静后达到出院标准的门诊患者的驾驶表现差于其陪同司机:模拟器的前瞻性观察研究。
背景:手术或门诊手术后达到麻醉后出院标准并不意味着患者恢复了所有的功能,如驾驶。尽管许多临床指南强制要求,但没有证据表明护送司机在深度镇静后减少交通事故的风险。本研究的目的是评估一种假设,即使用驾驶模拟测量的驾驶性能在接受深度镇静进行胃肠内窥镜检查符合出院标准的患者与其陪同人员之间不会有差异。方法:本前瞻性研究纳入深度异丙酚镇静下行动态胃肠内镜检查的患者(患者组)及其陪同人员(陪同组)。使用驾驶模拟器评估陪同人员和患者的驾驶表现(当满足出院标准时)。结果:纳入30例患者及其陪同人员。患者越过中线的频率明显高于陪同患者(3[2-4](中位数[IQR])和2[1-3]次,p=0.015)。与陪同人员相比,患者超速行驶的距离比例更高(患者和陪同人员分别为37(20)%(平均(SD))和24 (17)%,p = 0.029)。其他模拟参数组间差异无统计学意义。结论:在模拟驾驶过程中,通过中线穿越次数来衡量,在深度镇静下符合胃肠内窥镜检查出院标准的患者与陪同患者相比,保持在交通车道内的能力受损。这一发现并不支持让病人在手术后自己开车回家的做法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta gastro-enterologica Belgica
Acta gastro-enterologica Belgica Medicine-Gastroenterology
CiteScore
2.30
自引率
20.00%
发文量
78
期刊介绍: The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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