Srisawasdi Sureerat, Punjasawadwong Yodying, Werawatganon Thewarug, Pengpol Wiroj, Kongrit Prachumpon, Rodanant Oraluxna, Tanudsintum Surasak
Department of Anesthesiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2007 Aug;90(8):1558-64.
There is a continuing trend to have more elective surgical operations performed on an outpatient basis.
To determine the proportional distribution of anesthetic procedures performed in ambulatory elective surgery at different levels of hospitals across Thailand.
A prospective and descriptive study was conducted at 20 hospitals comprising seven universities, five regional, four general and four district hospitals across Thailand Consecutive outpatients who were undergoing elective surgical operation were included and their relevant data were selected and extracted for summary by using descriptive statistics.
From the database of 118,027 anesthetics performed for elective surgical operation, 7,786 (6.6%) were outpatients. According to this, 7,016 (90.1%) were practiced in university hospitals, 656 (8.4%) in regional or tertiary hospitals, 71 (9%) in general or provincial hospitals, and 43 (0.6%) in district hospitals. The frequency of the ambulatory anesthesia was higher in hospitals in the central region, especially in university hospitals in Bangkok than in other regions. The majority of cases (86%) received their initial pre-anesthetic evaluation in the operating room while 12% were evaluated at the outpatient office. About 28% of the cases presented with pre-anesthetic abnormal conditions. The relatively common pre-anesthetic diseases were hypertension, diabetes mellitus, anemia, arrhythmia, and asthma.
From the results of the present study, the authors have concluded that the rate of expansion of ambulatory anesthesia in Thailand is relatively slow, and varies according to the type of hospital and its geographic region. This indicates further studies should be formally conducted to determine factors affecting the practice of ambulatory surgery in Thailand. A large proportion of patients receive initial pre-anesthetic evaluation in the operating room on the day of surgery. This indicates that a system of pre-anesthetic evaluation should be set up for outpatients such as a pre-anesthetic care clinic should be set up for outpatients.
门诊进行更多择期外科手术的趋势仍在持续。
确定泰国不同级别医院门诊择期手术中麻醉方法的比例分布。
在泰国的20家医院开展了一项前瞻性描述性研究，这些医院包括7所大学医院、5所地区医院、4所综合医院和4所县级医院。纳入接受择期外科手术的连续门诊患者，并选取其相关数据，采用描述性统计方法进行汇总提取。
在为择期外科手术实施的118,027例麻醉数据库中，门诊患者有7,786例（6.6%）。据此，7,016例（90.1%）在大学医院实施，656例（8.4%）在地区或三级医院实施，71例（9%）在综合或省级医院实施，43例（0.6%）在县级医院实施。中部地区医院，尤其是曼谷的大学医院，门诊麻醉的频率高于其他地区。大多数病例（86%）在手术室接受首次麻醉前评估，而12%在门诊办公室接受评估。约28%的病例存在麻醉前异常情况。相对常见的麻醉前疾病为高血压、糖尿病、贫血、心律失常和哮喘。
根据本研究结果，作者得出结论，泰国门诊麻醉的扩张速度相对较慢，且因医院类型及其地理区域而异。这表明应正式开展进一步研究，以确定影响泰国门诊手术实施的因素。很大一部分患者在手术当天在手术室接受首次麻醉前评估。这表明应为门诊患者建立麻醉前评估系统，例如应为门诊患者设立麻醉前护理诊所。
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