术内芬太尼在内镜手术中的使用及其对PACU时间和成本的影响
Miho Akabane1, Kelsey Kukuruza1, Timothy Angelotti1
1Stanford University School of Medicine, Stanford, CA, USA.
Perioperative medicine (London, England)
|March 21, 2025
概括
术内使用芬太尼在内镜术中延长了每位患者的麻醉后护理单位 (PACU) 停留时间约为4分钟. 避免芬太尼可以节省大量的时间和成本,而不会影响疼痛管理.
科学领域:
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
- 卫生经济学 卫生经济学
背景情况:
- 麻醉后护理单位 (PACU) 在大容量内镜设置中仍然存在挑战.
- 术内芬太尼对PACU持续时间,疼痛和门诊内镜的成本的影响需要调查.
研究的目的:
- 评估手术内芬太尼对麻醉后护理单位 (PACU) 持续时间的影响.
- 评估芬太尼对术后疼痛评分的影响.
- 分析芬太尼在门诊内镜中使用的财务影响.
主要方法:
- 在2020-2022年期间进行的11,488次上/下内镜的回顾性分析.
- 芬太尼和非芬太尼组之间的PACU持续时间,疼痛评分 (数值评分表) 和财务数据的比较.
- 多变量分析以确定与长时间的PACU停留相关的因素.
主要成果:
- 接受手术内芬太尼的患者中位数PACU停留时间较长 (52分比48分,P<0.01).
- 芬太尼使用与数值评分尺度疼痛得分较高 (3.6%对1.2%,P<0.01) 相关,并且没有显著减少术后疼痛.
- 多变量分析确定了芬太尼使用,年龄较大和ASA得分较高 (≥3) 作为延长PACU持续时间的预测因素. 没有芬太尼的管理可以每年为机构节省超过10万美元.
结论:
- 在内镜内进行手术时使用芬太尼与增加PACU持续时间 (大约2个小时) 有关. 4分钟/患者). 这是一个很好的方法.
- 在这种情况下,芬太尼没有显著改善术后疼痛管理.
- 消除手术期间使用的芬太尼可以在门诊内镜中大大节省时间和成本.
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