妇科近距离治疗手术的镇痛和麻醉实践模式以及对妇女手术体验的潜在影响:全国调查。

IF 6.4 1区 医学 Q1 ONCOLOGY
Amanda Rivera, Dulce M Barrios, Emma Herbach, Jenna M Kahn, Vonetta M Williams, Keyur J Mehta, Aaron Wolfson, Lorraine Portelance, Mitchell Kamrava
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引用次数: 0

摘要

目的:确定目前美国妇科近距离放射治疗(BT)过程中的镇痛(AG)和麻醉(AS)实践模式:在2023年6月至10月期间,通过电子方式向90个美国放射肿瘤学术项目分发了一份由5名近距离治疗师提供专业知识的27项调查问卷,并在社交媒体和两次全国性会议上进行了宣传:共收到 41 份回复(46%)。54%为女性,66%为白种人,85%为非西班牙裔/拉丁裔。49%的人单独使用 BT 套件 +/- CT 模拟器,39%的人使用手术室 +/- BT 套件或 CT 模拟器或其他地点,10%的人单独使用 CT 模拟室,2%的人使用诊所检查室。34%的腔内 BT 使用单独的全身麻醉 (GA)(n=41),20% 使用单独的意识镇静 (CS),10% 使用单独的口服镇痛 (OA),9% 使用单独的脊髓或硬膜外 AS,27% 使用联合麻醉。在进行混合 BT 的患者(人数=25)中,40% 单独使用 GA,16% 单独使用 CS,12% 单独使用硬膜外或脊髓 AS,4% 单独使用 OA,28% 合并使用。对于模板间隙 BT(人数=25),44% 单独使用 GA,48% 单独使用硬膜外或与其他 AS 结合使用,8% 单独使用 CS。22%的受访者仅在置入涂抹器时使用 AG 或 AS,32%的受访者在置入、计划、治疗和移除过程中使用 AG 或 AS。不使用 CS 或 GA 的最常见原因是缺乏麻醉资源和临床医生的偏好。73%的人认为患者在 BT 后会出现创伤后应激障碍 (PTSD) 症状。然而,68%的人表示没有使用技术来缓解与 BT 相关的情绪困扰:结论:许多美国胸椎治疗师表示使用了GA、CS或硬膜外AS,但10%的人只使用了OA,22%的人只在放置涂药器时提供AG/AS。此外,大多数受访者认为 BT 后会出现创伤后应激障碍症状,但很少有人提供任何干预措施。应针对 AS 资源和临床医生的偏好扩大更高质量的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analgesia and Anesthesia Practice Patterns for Gynecologic Brachytherapy Procedures and Potential Impact on Women's Procedural Experience: A National Survey.

Purpose: The purpose of this study was to determine the current U.S. practice patterns of analgesia (AG) and anesthesia (AS) for gynecologic brachytherapy (BT) procedures.

Methods and materials: A 27-item survey created with expertise from 5 brachytherapists was distributed electronically to 90 U.S. radiation oncology academic programs and publicized on social media and at 2 national meetings from June to October 2023.

Results: Forty-one responses were received (46%). Fifty-four percent identified as female, 66% as Caucasian, and 85% as non-Hispanic/Latino ethnicity. Forty-nine percent use a BT suite ± computed tomography (CT) simulator alone, 39% the operating room ± BT suite or CT simulator or other location, 10% CT simulation room alone, and 2% clinic examination room. Thirty-four percent use general anesthesia alone (GA) for intracavitary BT (n = 41), 20% conscious sedation (CS) alone, 10% oral analgesia (OA) alone, 9% spinal or epidural AS alone, and 27% combination. Among those performing hybrid BT (n = 25), 40% use GA alone, 16% use CS alone, 12% epidural or spinal AS alone, 4% OA alone, and 28% combination. For template interstitial BT (n = 25), 44% use GA alone, 48% epidural alone or in combination with other AS, and 8% CS alone. Twenty-two percent of respondents provide AG or AS during applicator placement only, whereas 32% provide it during placement, planning, treatment, and removal. The most common reasons for not using CS or GA were the lack of AS resources and clinician preference. Seventy-three percent reported the belief that patients suffer from post-traumatic stress disorder symptoms after BT. However, 68% reported not using techniques to alleviate BT-related emotional distress.

Conclusions: Many U.S. brachytherapists report using GA, CS, or epidural AS; however, 10% are using only OA, and 22% offer AG/AS only during applicator placement. Furthermore, a majority of respondents believe post-traumatic stress disorder symptoms can occur after BT, but few offer any intervention. AS resources and clinician preferences should be targeted for the expansion of higher-quality care.

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来源期刊
CiteScore
11.00
自引率
7.10%
发文量
2538
审稿时长
6.6 weeks
期刊介绍: International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field. This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.
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