Perrott David H, Yuen Judy P, Andresen Randi V, Dodson Thomas B
American Association of Oral and Maxillofacial Surgeons, Rosemont, IL, USA.
J Oral Maxillofac Surg. 2003 Sep;61(9):983-95; discussion 995-6. doi: 10.1016/s0278-2391(03)00668-2.
The delivery of office-based ambulatory anesthesia services is an integral component of the daily practice of oral and maxillofacial surgeons (OMSs). The purpose of this report was to provide an overview of current anesthetic practices of OMSs in the office-based ambulatory setting.
To address the research purpose, we used a prospective cohort study design and a sample composed of patients undergoing procedures in the office-based ambulatory setting of OMSs practicing in the United States who received local anesthesia (LA), conscious sedation (CS), or deep sedation/general anesthesia (DS/GA). The predictor variables were categorized as demographic, anesthetic technique, staffing, adverse events, and patient-oriented outcomes. Appropriate descriptive and bivariate statistics were computed as indicated. Statistical significance was set at < or =.05.
The sample was composed of 34,191 patients, of whom 71.9% received DS/GA, 15.5% received CS, and 12.6% received LA. The complication rate was 1.3 per 100 cases, and the complications were minor and self-limiting. Two patients had complications requiring hospitalization. Most patients (80.3%) reported some degree of anxiety before the procedure. After the procedure, 61.2% of patients reported having no anxiety about future operations. Overall, 94.3% of patients reported satisfaction with the anesthetic, and more than 94.7% of all patients would recommend the anesthetic technique to a loved one.
The findings of this study show that the office-based administration of LA, CS, or DS/GA delivered via OMS anesthesia teams was safe and associated with a high level of patient satisfaction.
提供门诊麻醉服务是口腔颌面外科医生(OMS)日常工作的一个重要组成部分。本报告的目的是概述OMS在门诊环境中的当前麻醉实践。
为实现研究目的,我们采用了前瞻性队列研究设计,样本由在美国从事门诊手术的OMS团队进行局部麻醉(LA)、清醒镇静(CS)或深度镇静/全身麻醉(DS/GA)的患者组成。预测变量分为人口统计学、麻醉技术、人员配备、不良事件和以患者为导向的结果。根据需要计算适当的描述性和双变量统计量。统计学显著性设定为<或=0.05。
样本包括34191名患者,其中71.9%接受DS/GA,15.5%接受CS,12.6%接受LA。并发症发生率为每100例1.3例,并发症轻微且为自限性。两名患者出现需要住院治疗的并发症。大多数患者(80.3%)在手术前报告有一定程度的焦虑。手术后,61.2%的患者报告对未来手术没有焦虑。总体而言,94.3%的患者对麻醉表示满意,超过94.7%的患者会向亲人推荐该麻醉技术。
本研究结果表明,由OMS麻醉团队在门诊实施LA、CS或DS/GA是安全的,并且患者满意度很高。