在全身麻醉期间,非洲裔美国人和非西班牙裔白人患者在手术期间使用药物的差异:回顾性观察队列研究
Hideyo Tsumura1,2, Wei Pan1,3, Debra Brandon1,3
1Duke University School of Nursing, Durham, NC, USA.
麻醉治疗显示了种族差异. 非洲裔美国患者接受了更多的米达佐拉姆和抗高血压药物,但比白人患者少服用抗高血压药物. 阿片类药物和sugammadex的使用没有显著差异.
科学领域:
- 麻醉学 麻醉学
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 在医疗保健领域的种族和民族差异已经得到了充分的证据.
- 了解手术期间使用药物的变化对于公平的麻醉护理至关重要.
研究的目的:
- 调查非裔美国人和非西班牙裔白人患者在非心胸外科和非产科手术中接受全身麻醉的手术内药物的种族差异.
- 识别可能存在使用差异的特定药物.
主要方法:
- 追溯观察队列研究利用来自大型学术卫生系统的电子健康记录 (2018年1月 - 2019年8月).
- 使用治疗权重的逆概率 (IPTW) 来平衡种族群体之间的共变量.
- 回归分析评估了种族对使用阿片类止痛药,米达佐拉姆,苏加马德克斯,抗低血压和抗高血压药物的影响.
主要成果:
- 与非西班牙裔白人患者相比,非洲裔美国患者更有可能接受米达佐拉姆前期治疗 (aOR=1.17) 和抗高血压药物 (aOR=1.15) .
- 与非西班牙裔白人患者相比,非洲裔美国患者接受抗低血压药物的可能性较小 (aOR=0.85).
- 组之间在阿片类止痛药总剂量或sugammadex的使用中没有发现显著差异.
结论:
- 这项研究揭示了基于种族的手术内麻醉药物输送的显著差异.
- 需要进一步的研究,以阐明导致这些差异的潜在机制及其对患者结果的潜在影响.
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