未来试点研究:在护理人员管理的有意识镇静下,门诊阴茎缩的耐受性与麻醉师管理的深度镇静相比
Dhiraj S Bal1, Maximilian Fidel1, Jainik Shah1
1Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Urology practice
|June 20, 2024
概括
皮罗尼病的阴茎缩在有意识的镇静下 (CS) 是可以很好地容忍的,无论是麻醉科医生还是护士给药. 这种方法为全身麻醉提供了安全,经济高效的替代方案,减少了门诊手术的风险和等待时间.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 麻醉学 麻醉学
背景情况:
- 阴茎折叠是皮罗尼病的标准程序,通常在全身或脊髓麻醉下进行.
- 意识镇静 (CS) 具有潜在的好处,包括降低麻醉风险,节省成本,并适用于有较短等待时间的门诊机构.
研究的目的:
- 为了比较由麻醉师管理的深静脉镇静 (DIS) 下的阴茎增殖的耐受性与护理管理的CS (NACS).
主要方法:
- 进行了关于阴茎折叠耐受性的前性评估,不包括修复手术和特定的阴茎形.
- 两种镇静方法进行了比较:DIS (midazolam,ketamine,propofol,remifentanil) 和NACS (midazolam,fentanyl). 这两种镇静方法是不同的.
- 收集的数据包括患者和外科医生报告的疼痛评估以及程序后标准化耐受性问卷.
主要成果:
- 招募了40名患者 (23 DIS; 17 NACS),具有可比的基线特征和中位曲线.
- 在没有手术堕胎或转换为全身麻醉的情况下,实现了100%的成功率.
- 所有患者都实现了功能曲 (<20°),超过93%的人更喜欢在未来的手术中使用CS,两组之间疼痛没有显著差异.
结论:
- 在CS下,无论是麻醉科医生或护士给药,阴茎折叠都能很好地忍受,疼痛和并发症的发生率相似.
- 由训练有素的护理人员管理的使用CS的门诊阴茎复合可以有效地降低成本,风险和程序等待时间.
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