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采用镇静服务模式在门诊进行小儿眼科手术的深度镇静。

Office-based deep sedation for pediatric ophthalmologic procedures using a sedation service model.

作者信息

Lalwani Kirk, Tomlinson Matthew, Koh Jeffrey, Wheeler David

机构信息

Department of Anesthesiology and Peri-operative Medicine and Department of Ophthalmology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.

出版信息

Anesthesiol Res Pract. 2012;2012:598593. doi: 10.1155/2012/598593. Epub 2012 Mar 14.

Abstract

Aims. (1) To assess the efficacy and safety of pediatric office-based sedation for ophthalmologic procedures using a pediatric sedation service model. (2) To assess the reduction in hospital charges of this model of care delivery compared to the operating room (OR) setting for similar procedures. Background. Sedation is used to facilitate pediatric procedures and to immobilize patients for imaging and examination. We believe that the pediatric sedation service model can be used to facilitate office-based deep sedation for brief ophthalmologic procedures and examinations. Methods. After IRB approval, all children who underwent office-based ophthalmologic procedures at our institution between January 1, 2000 and July 31, 2008 were identified using the sedation service database and the electronic health record. A comparison of hospital charges between similar procedures in the operating room was performed. Results. A total of 855 procedures were reviewed. Procedure completion rate was 100% (C.I. 99.62-100). There were no serious complications or unanticipated admissions. Our analysis showed a significant reduction in hospital charges (average of $1287 per patient) as a result of absent OR and recovery unit charges. Conclusions. Pediatric ophthalmologic minor procedures can be performed using a sedation service model with significant reductions in hospital charges.

摘要

目的。(1)使用儿科镇静服务模式评估儿科门诊镇静用于眼科手术的有效性和安全性。(2)评估与手术室(OR)环境下进行类似手术相比,这种护理模式下医院费用的降低情况。背景。镇静用于辅助儿科手术,并使患者在成像和检查时保持固定状态。我们认为儿科镇静服务模式可用于辅助在门诊进行简短的眼科手术和检查时进行深度镇静。方法。经机构审查委员会(IRB)批准后,利用镇静服务数据库和电子健康记录识别出2000年1月1日至2008年7月31日期间在我们机构接受门诊眼科手术的所有儿童。对手术室中类似手术的医院费用进行了比较。结果。共审查了855例手术。手术完成率为100%(置信区间99.62 - 100)。没有严重并发症或意外入院情况。我们的分析表明,由于无需手术室和恢复室费用,医院费用显著降低(平均每位患者1287美元)。结论。使用镇静服务模式可以进行儿科眼科小手术,同时显著降低医院费用。

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Organizational prerequisites for anesthesia outside the operating room.手术室以外麻醉的组织前提条件。
Curr Opin Anaesthesiol. 2009 Aug;22(4):514-8. doi: 10.1097/ACO.0b013e32832dbac0.
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Pediatric sedation/anesthesia outside the operating room.手术室以外的儿科镇静/麻醉
Curr Opin Anaesthesiol. 2008 Aug;21(4):494-8. doi: 10.1097/ACO.0b013e3283079b6c.
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Curr Opin Anaesthesiol. 2005 Jun;18(3):271-6. doi: 10.1097/01.aco.0000169234.06433.48.
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Office-based anesthesia for children.儿童门诊麻醉
Anesthesiol Clin North Am. 2002 Mar;20(1):195-210. doi: 10.1016/s0889-8537(03)00061-0.

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