限制使用二在老年人麻醉中的策略:一项随机临床试验
Mark D Neuman1,2, Rui Feng3,4, Aesha S Shukla5
1Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia.
JAMA network open
|October 31, 2024
概括
临床医生反和患者邮件并没有减少在麻醉期间在老年患者中使用二. 患者满意度仍然很高,这表明需要采取替代干预措施来改善对这一群体的护理.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 提高质量 提高质量
背景情况:
- 准则建议在老年患者中避免使用二类药物,因为有风险.
- 目前的干预措施,以减少在这个人群中使用二胺是不够研究.
研究的目的:
- 为了评估临床医生同行比较和患者信息邮件对老年人周围手术时使用二甲的影响.
- 为了比较这些干预措施,单独或组合,与通常的护理.
主要方法:
- 一个2x2因子,阶梯,集群随机临床试验,涉及415个医疗保健机构.
- 超过50万65岁以上的成年患者接受了随机的全身麻醉选择性手术.
- 干预措施包括临床医生同行比较,患者信息邮件,两者,或通常的护理.
主要成果:
- 与常规护理相比,没有一个测试的干预措施显著降低了二甲的使用.
- 临床医生同行比较 (OR,1.02) 和患者邮件 (OR,1.01) 显示没有显著差异.
- 综合干预显示,几率的非显著增加 (OR, 1.11).
- 在所有组中,患者满意度仍然很高.
结论:
- 临床医生同行比较和患者信息邮件在减少老年手术患者使用二甲方面是无效的.
- 对新的,以患者为中心的干预措施进行进一步的研究是必要的,以优化对老年人的麻醉护理.
- 患者满意度高表明,目前的麻醉治疗一般耐受良好.
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