Thikkurissy Sarat, Smiley Megann, Casamassimo Paul S
Ohio State University College of Dentistry, Columbus, OH 43218, USA.
Anesth Prog. 2008 Summer;55(2):35-9. doi: 10.2344/0003-3006(2008)55[35:CACBCP]2.0.CO;2.
The objectives of this study were to compare history and physical examinations (H&Ps) done by community-based physicians and dentist anesthesiologists for children undergoing general anesthesia for dental rehabilitation. One hundred sixty-eight records were evaluated from the Nationwide Children's Hospital Dental Surgery Center of patients anesthetized between June 2006 and March 2007. These patients had H&Ps completed by both a community-based physician and a dentist anesthesiologist prior to general anesthesia. H&P forms were reviewed by the 3 authors to identify missing data, American Society of Anesthesiologists (ASA) classification, and impact on care. There was a statistically significant difference with respect to 10 of 17 sections examined, with the community-based physicians' H&Ps tending to be incomplete more often. Over 20% of community-based physicians made no mention of the history of present illness. One third of all physician H&Ps were missing vital sign recordings. No significant difference was noted between the physicians' and dentist anesthesiologists' ratings of ASA status. The physician H&P altered course of anesthesia treatment in <1% of studied cases. Statistically significant deficiencies were noted in the physician H&P in 60% of categories.
本研究的目的是比较社区医生和牙科麻醉医生对接受牙科修复全身麻醉的儿童进行的病史和体格检查(H&P)情况。对全国儿童医院牙科手术中心2006年6月至2007年3月期间接受麻醉的患者的168份记录进行了评估。这些患者在全身麻醉前由社区医生和牙科麻醉医生分别完成了H&P。三位作者对H&P表格进行了审查,以确定缺失的数据、美国麻醉医师协会(ASA)分级以及对治疗的影响。在所检查的17个部分中的10个部分存在统计学上的显著差异,社区医生的H&P往往更常不完整。超过20%的社区医生未提及现病史。所有医生的H&P中有三分之一缺失生命体征记录。医生和牙科麻醉医生对ASA状态的评级之间未发现显著差异。在<1%的研究病例中,医生的H&P改变了麻醉治疗过程。在60%的类别中,医生的H&P存在统计学上的显著缺陷。