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证明常规麻醉师参与急性中风护理的价值:回顾性图表审查

Robert J McCusker¹, Vernon M Chinchilli², Chanju D Fritch³

¹Department of Anesthesiology and Perioperative Medicine.

Journal of neurosurgical anesthesiology

|July 13, 2023

概括

常规麻醉师参与急性缺血性中风的内血管血栓切除术 (EVT) 提高了工作流程的效率和准则的遵守. 虽然它不会影响患者的结果,但它简化了程序,并增强了生理参数管理.

科学领域:

神经学神经学
麻醉学麻醉学
干预性放射学干预性放射学

背景情况:

对于急性缺血性中风的内血管血栓切除术 (EVT) 中常规麻醉师参与的必要性尚不清楚.
实践有所不同,有些中心只在需要时涉及麻醉师,而另一些中心则要求他们在每次EVT手术中都出席.

研究的目的:

评估常规麻醉师参与对EVT患者工作流程,程序变量,并发症和结果的影响.
为了比较常规麻醉团队参与管理的患者与接受镇静训练的护士和必要时的麻醉师支持管理的患者之间的结果.

主要方法:

对在综合性中风中心接受EVT的急性缺血性中风患者的回顾性分析.
对比一组常规麻醉团队参与的队列与一组根据需要的麻醉师支持的队列.
分析包括工作流量指标,程序内变量,并发症和90天修改的Rankin分数.

主要成果:

常规麻醉师的参与与显著减少门到动脉穿刺时间,室内到动脉穿刺时间和手术时间有关.
观察到一种趋势,即脱度事件的降低率和转换为全身麻醉的减少,尽管在统计学上并不显著.
九十天修改的兰金评分在两组之间是可比的,表明患者结局没有显著差异.

结论:

在EVT期间,常规麻醉师参与改善了程序效率和遵守基于指南的生理参数.
虽然没有直接改善患者的结果,但提高效率支持麻醉科医生在EVT程序中的常规整合.
这一发现支持标准化麻醉支持以优化EVT工作流程.

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