关于期望和疼痛控制在外科手术中的进步的随机试验:REPAIR研究
Tasha R Serna-Gallegos1, Yuko M Komesu1, Gena C Dunivan1
1From the Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics and Gynecology.
Urogynecology (Philadelphia, Pa.)
|July 10, 2023
概括
患者为中心的手术前教育并没有减少泌尿外科手术后的麻醉剂使用. 然而,共享处方决策减少了处方和未使用的麻醉剂,改善了术后实践.
科学领域:
- 泌尿和妇科 泌尿和妇科
- 外科教育的外科教育
- 疼痛管理 疼痛管理
背景情况:
- 手术后的麻醉药物处方做法需要优化.
- 以患者为中心的手术前教育和共享决策 (SDM) 是改善结果的潜在策略.
研究的目的:
- 评估以患者为中心的手术前教育和SDM对泌尿外科手术患者术后麻醉剂处方和消费的影响.
- 评估对患者满意度,准备,恢复活动和疼痛干扰的影响.
主要方法:
- 随机对照试验比较标准的手术前教育与以患者为中心的教育以及标准的麻醉剂处方与患者选择麻醉剂量的SDM.
- 参与者接受了泌尿外科手术,并随机分为两个组.
- 结果包括麻醉剂消费,处方和未使用的数量,患者满意度,准备,恢复活动和疼痛干扰.
主要成果:
- 在标准组和以患者为中心的组之间,麻醉品的消费没有显著差异.
- 以患者为中心的小组,利用SDM,与标准组相比,处方和未使用的麻醉药物显著减少.
- 两组之间没有观察到患者满意度,准备度,恢复功能或疼痛干扰方面的显著差异.
结论:
- 仅仅以患者为中心的教育并没有降低术后麻醉剂的消费.
- 在麻醉药物处方方面,共享决策是可行的,有效地减少了处方和未使用的麻醉药物.
- 在泌尿外科手术中,SDM显示出改善术后麻醉药物处方实践的前景.
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