手术镇静过程中的病人监测:乌克兰是否实施了现代标准?

K. Bielka, M. Frank, I. Kuchyn, M. Didenko, N. Semenko
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引用次数: 1

摘要

该研究的目的是审查关于在程序性镇静和镇痛过程中监测患者的现代建议,并评估其是否符合乌克兰的现代标准。材料和方法。本文回顾了2003年至2023年间发表的欧洲、美国、英国和澳大利亚组织关于程序性镇静和镇痛或符合ASA(麻醉期间标准监测)的程序性镇静的麻醉水平的建议。从3月17日到20日进行了一次调查。在整个调查过程中,参与者通过谷歌表格匿名填写了一份调查问卷。在乌克兰麻醉师协会的支持下,博戈莫雷茨国立医科大学研究生教育研究所麻醉学和重症监护系通过Facebook和Instagram等社交网络在博戈莫雷茨国立医科大学外科、麻醉学和重症监护系官方页面上分享了问卷的链接。结果。共有284名医生参与了调查。其中280人(98.5%)在调查期间一直在乌克兰工作,4人(1.5%)被排除在分析之外。脉搏血氧测量是经常使用到278年(99.2%)、自动测量动脉压到222年(79.4%)、手动测量动脉压的35(12.5%)、心电监测到95年(34.2%)、capnography由35(12.5%)、温度测量10(3.5%)、4(1.6%)脑电图的医生(图3)。36个(12.8%)的受访者了解缺乏技术手段进行心电监护的情况下,172年(62.5%)进行了选择性的方式。结果以描述性统计和图表的形式呈现。结论。如果系统地遵循现代安全标准,程序性镇静是一种安全的方法。充分监测是及时应对重大事件和减轻其后果的先决条件。报告镇静期间发生的任何严重程度的问题有助于优化当地做法,并对医疗保健质量产生积极影响。引入常规心电图、心电图和体温计是乌克兰提高监测质量的优先目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PATIENT MONITORING DURING PROCEDURAL SEDATION: ARE THE MODERN STANDARDS IMPLEMENTED IN UKRAINE?
The purpose of the study was to review modern recommendations regarding the monitoring of patients during procedural sedation and analgesia as well as to assess its conformity to the modern standards in Ukraine. Materials and methods. Recommendations from European, American, British and Australian organizations which cover the topic of procedural sedation and analgesia or levels of anesthesia that conform to the procedural sedation corresponding to ASA, the standard monitoring during anesthesia, and were published between 2003 and 2023 have been reviewed. From 17 till 20th of March a survey has been conducted. Throughout the survey, participants have anonymously filled a questionnaire via Google-Form. The link to the questionnaire was shared by the Department of Anesthesiology and Intensive Care of the Institute of Postgraduate Education of Bogomolets National University with support provided by Association of Anesthesiologists of Ukraine through social networks such as Facebook and Instagram on the official pages of the Department of Surgery, Anesthesiology, and Intensive Care of the Institute of Postgraduate Education of the Bogomolets National Medical University. Results. A total of 284 doctors took part in the survey. Among them 280 (98.5 %) have been working in Ukraine during the survey, 4 (1.5 %) have been excluded from the analysis. Pulse oximetry was regularly used by 278 (99.2 %), automatic arterial pressure measurement by 222 (79.4 %), manual measurement of arterial pressure by 35 (12.5 %), ECG-monitoring by 95 (34.2 %), capnography by 35 (12.5 %), thermometry by 10 (3.5 %), electroencephalography by 4 (1.6 %) of the doctors (Fig. 3). 36 (12.8 %) of the respondents have informed about the absence of technical means to conduct ECG-monitoring, 172 (62.5 %) have conducted it in a selective manner. The results are presented in form of descriptive statistics and diagrams. Conclusion. Procedural sedation is a safe method provided that modern safety standards are systematically followed. Full monitoring is a prerequisite for timely response to critical events and mitigation of their consequences. Reporting problems of any degree of criticality that occurred during sedation helps to optimize local practices and has a positive effect on the quality of medical care. Introduction of routine capnography, electrocardiography and thermometry are prioritized goals when it comes to increasing the quality of monitoring in Ukraine.
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