Fink H, Geldner G, Fuchs-Buder T, Hofmockel R, Ulm K, Wallek B, Blobner M
Klinik für Anästhesiologie, Klinikum rechts der Isar, Technische Universität, Ismaninger Strasse 22, 81675 München.
Anaesthesist. 2006 Jun;55(6):668-78. doi: 10.1007/s00101-006-1015-6.
Aim of this study was to evaluate application customs of muscles relaxants in hospitals compared to their use in private practice. Of the 3,260 questionnaires sent-out, 66.9% could be analyzed. Of these 54% were from anesthetists in private practice, 41% from heads of hospital anesthesia departments and 5% from heads of level one hospital anesthesia departments. The first difference between private practices and hospitals was the number of available muscle relaxants: 87% of private practices use 1-3 relaxants, whereas 79% of hospitals use 3-5. Another apparent difference was the relationship between general anesthesia and the number of intubations: 60% of private practices have over 80% of general anesthesia cases, but only 50% of these patients are intubated. On the contrary, two thirds of the hospitals have 50-80% general anesthesia cases and 60-70% of patients are intubated. The main wish for an ideal muscle relaxant was independent of private practice or hospital, short onset time, followed by fast recovery. In accordance 74% of anesthetists in hospitals and 72% of anesthetists in private practice voiced the wish for a non-depolarizing succinylcholine substitute. The results of this nationwide survey suggest that time pressure in combination with an increased specialization of anesthetists in private practice are the main factors for availability and use of muscle relaxants in routine anesthesia.
本研究的目的是评估肌肉松弛剂在医院的应用习惯,并与在私人诊所的使用情况进行比较。在发出的3260份问卷中,66.9%可以进行分析。其中,54%来自私人诊所的麻醉师,41%来自医院麻醉科主任,5%来自一级医院麻醉科主任。私人诊所和医院之间的第一个差异是可用肌肉松弛剂的数量:87%的私人诊所使用1 - 3种松弛剂,而79%的医院使用3 - 5种。另一个明显的差异是全身麻醉与插管数量之间的关系:60%的私人诊所全身麻醉病例超过80%,但这些患者中只有50%进行了插管。相反,三分之二的医院全身麻醉病例占50 - 80%,60 - 70%的患者进行了插管。对于理想肌肉松弛剂的主要期望与私人诊所或医院无关,即起效时间短,其次是恢复快。相应地,74%的医院麻醉师和72%的私人诊所麻醉师表示希望有非去极化琥珀酰胆碱替代品。这项全国性调查的结果表明,时间压力以及私人诊所麻醉师专业化程度的提高是常规麻醉中肌肉松弛剂可用性和使用的主要因素。