Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada.
Radiology. 2010 Jul;256(1):229-37. doi: 10.1148/radiol.10091124. Epub 2010 May 26.
To determine the effect of sedative and anesthetic administration on the duration and costs of pediatric magnetic resonance (MR) imaging.
This prospective study was approved by the institutional research ethics board; informed consent and/or assent was obtained from all participants or their parents. A patient flow study was conducted in a pediatric MR imaging clinic in which research assistants tracked participants' progress through the clinic. Demographic, visit process, and medication information was collected for 237 participants, categorized as awake, sedated, or anesthetized. The data were analyzed to (a) determine total visit duration differences, (b) investigate variations in visit stage durations according to patient type, and (c) estimate visit costs on the basis of human resource and medication use. Linear regression, the Shapiro-Wilk test, the two-tailed t test, and the nonparametric Mann-Whitney test were used.
Complete data sets were obtained for 148 awake, 28 sedated, and 27 anesthetized participants. Data revealed 12 stage sequences among patient visits; dominant sequences differed according to patient category. An awake patient's average visit duration (2 hours 21 minutes) differed significantly from that of sedated (3 hours 38 minutes, P < .001) and anesthetized (4 hours 7 minutes, P < .001) patients; sedated and anesthetized visit durations did not differ significantly (P < .073), although this finding may be attributable to the small sample sizes. Variation in stage durations was also evident within and among patient types. Visit costs for sedated and anesthetized patients were 3.24 and 9.56 times higher, respectively, than those for awake patients. Costs for anesthetized patients were 2.95 times higher than those for sedated patients.
Visit durations were significantly longer for anesthetized and sedated patients. Anesthetized patients incurred the highest costs, followed by sedated patients.
确定镇静和麻醉管理对儿科磁共振成像（MR）检查时间和费用的影响。
本前瞻性研究获得了机构研究伦理委员会的批准；所有参与者或其父母均获得了知情同意书和/或同意书。在儿科磁共振成像诊所进行了一项患者流程研究，研究助理跟踪参与者在诊所的进展情况。收集了 237 名参与者的人口统计学、就诊流程和用药信息，分为清醒、镇静和麻醉组。对数据进行分析，以确定总就诊时间差异，（b）根据患者类型调查就诊阶段时间的变化，以及（c）根据人力资源和药物使用情况估算就诊费用。采用线性回归、Shapiro-Wilk 检验、双尾 t 检验和非参数 Mann-Whitney 检验。
获得了 148 名清醒、28 名镇静和 27 名麻醉患者的完整数据集。数据显示患者就诊有 12 个阶段序列；主导序列根据患者类别而不同。清醒患者的平均就诊时间（2 小时 21 分钟）与镇静（3 小时 38 分钟，P<.001）和麻醉（4 小时 7 分钟，P<.001）患者显著不同；镇静和麻醉患者的就诊时间无显著差异（P<.073），尽管这一发现可能归因于样本量小。不同患者类型内和间的阶段时间也存在差异。镇静和麻醉患者的就诊费用分别比清醒患者高 3.24 倍和 9.56 倍。麻醉患者的就诊费用比镇静患者高 2.95 倍。
麻醉和镇静患者的就诊时间明显延长。麻醉患者的费用最高，其次是镇静患者。
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