Charpak Y, Nicoulet I, Bléry C
EVAL, Paris.
Ann Fr Anesth Reanim. 1992;11(5):576-83. doi: 10.1016/s0750-7658(05)80763-4.
A telephone enquiry was undertaken to assess current practice among French anaesthetists, and to obtain their opinion, concerning preoperative laboratory screening tests. It included 204 anaesthetists, randomly selected from the membership directory of the French Society of Anaesthetics and Intensive Care. The sample was concordant with the distribution (sex and age) given by the specialists' list of the National Medical Council. It comprised 64.2% male anaesthetists, and the overall mean age was 44.2 years. On average, each anaesthetist carried out 26 elective and 4 emergency anaesthetist a week. An organized preanaesthetic consultation was available in only 73% of public hospitals. However, even when existing, it does not automatically concern all surgical stations of the hospital and only 59% of patients benefit from that consultation. In 55% of patients the screening tests had still been made before the preanaesthetic consultation for scheduled surgery. About 15% of patients were seen for the first time by an anaesthetist on the very day of surgery. A routine prescription of preoperative tests was not systematic. Non prescription ranged from 7 to 34% of patients, depending on the tests. The responders recognized that for the same tests the rate could be comprised between 21 and 66% of patients. Moreover, 38% of anaesthetists admitted that sometimes they did not see results of the prescribed tests before carrying out the anaesthetic. Overprescription of preoperative tests has been recognized. However, legal, organisational, relational or economical reasons are given which may explain difficulties met with to rationalize prescription of these tests.
通过电话询问对法国麻醉师目前的做法进行了评估，并就术前实验室筛查测试征求了他们的意见。调查对象包括从法国麻醉与重症监护学会会员名录中随机抽取的204名麻醉师。该样本与国家医学委员会专家名单给出的分布情况（性别和年龄）相符。其中男性麻醉师占64.2%，总体平均年龄为44.2岁。每位麻醉师平均每周进行26例择期麻醉和4例急诊麻醉。只有73%的公立医院设有有组织的麻醉前会诊。然而，即便设有会诊，也并非覆盖医院的所有手术科室，只有59%的患者能从中受益。在55%的患者中，术前筛查测试在预定手术的麻醉前会诊之前就已进行。约15%的患者是在手术当天首次由麻醉师接诊。术前测试的常规开单并不系统。未开单的患者比例在7%至34%之间，具体取决于测试项目。受访者承认，对于相同的测试项目，未开单的患者比例可能在21%至66%之间。此外，38%的麻醉师承认，有时他们在实施麻醉前并未查看所开测试项目的结果。术前测试过度开单的情况已得到认可。不过，也给出了一些法律、组织、人际关系或经济方面的原因，这些原因或许可以解释在使这些测试的开单合理化方面所遇到的困难。
