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日本的儿科静脉麻醉 - 麻醉师在哪里?
Shun Toriumi1, Eisuke Inage1, Yuko Tanaka1
1Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine.
The Tohoku journal of experimental medicine
|June 26, 2024
概括
在日本,小儿静脉麻醉很少由麻醉师进行,即使在报销变化之后. 目前的系统需要改进,以确保在手术室外儿童的安全麻醉实践.
科学领域:
- 麻醉学 麻醉学
- 儿科麻醉 儿科麻醉
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在日本,小儿静脉麻醉主要由非麻醉师在手术室外进行.
- 2020年的一项修订旨在增加麻醉师长期静脉麻醉 (3类) 的报销,但其实际影响仍然不清楚.
研究的目的:
- 分析不同类别和年龄组的儿科静脉麻醉利用趋势.
- 调查2020年报销修订对麻醉实践的影响.
- 检查小儿麻醉管理中的区域差异.
主要方法:
- 分析了2018-2020财政年度的国家补偿数据.
- 对静脉注射麻醉类别和年龄分布的年度计算进行检查.
- 评估儿科麻醉补充人均计算率和区域差异.
主要成果:
- 在2019财年,超过56,000个儿科静脉静脉麻醉程序进行,由专家进行的3类麻醉很少 (0%门诊,3.9%住院患者).
- 在2020财年,3类手术仍然很低 (0.7%的门诊患者,2.0%的住院患者),这表明报销变化的影响不足.
- 总体而言,尽管COVID-19大流行,静脉麻醉的总数保持稳定,但在计算率方面观察到显著的区域差异.
结论:
- 麻醉学家长期的静脉内全麻醉在日本很少被使用.
- 目前的补偿改进不足以促进专业麻醉师参与儿科全静脉麻醉.
- 需要开发一种系统,以确保非麻醉师对儿科患者进行安全的静脉麻醉.
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