减少差异:在标准化区域麻醉途径内进行重建的乳腺切除区域麻醉块
Perri S Vingan1, Joanna Serafin2, Lillian Boe3
1Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Annals of surgical oncology
|February 23, 2024
概括
乳腺切除术重建的区域麻醉阻塞被广泛接受,但差异仍然存在. 未来的努力应该集中在教育上,以解决特定年龄,种族和保险群体的患者犹.
科学领域:
- 麻醉学 麻醉学
- 整形外科 整形外科 整形外科
- 健康差异 在健康上的差异
背景情况:
- 在乳房重建中使用区域麻醉的差异被注意到.
- 标准化的区域麻醉途径在大量的实践中得到实施.
研究的目的:
- 为了确定与接受或拒绝神经阻塞相关的因素,在接受乳腺切除并立即进行组织扩展器重建的患者中.
- 评估一个标准化的区域麻醉计划对区块接收的影响.
主要方法:
- 从2017年到2022年,对4213名经历乳房切除术并立即进行组织扩展器重建的患者进行了回顾性审查.
- 所有患者都被提供了手术前的神经阻塞;对于非英语说话者,使用翻译.
- 使用单变量和多变量逻辑回归来比较接受与拒绝神经阻塞的患者.
主要成果:
- 91%的患者接受了神经阻塞,而9%的人拒绝了.
- 拒绝阻断与年龄较大,西班牙裔种族,医疗补助保险,单方面手术和早期研究年龄有关.
- 区块拒绝率从2017年的12%下降到2022年的6%.
结论:
- 一个标准化的区域麻醉计划,为所有患者提供阻塞,可以减少种族差异.
- 基于年龄,种族和保险状况的接受度持续存在差异,凸显了针对性教育干预的必要性.
- 解决特定亚群体患者的犹对于公平护理至关重要.
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