Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX37LD, UK.
Knee Surg Sports Traumatol Arthrosc. 2013 Jul;21(7):1510-5. doi: 10.1007/s00167-012-2149-5. Epub 2012 Aug 2.
Day case knee arthroscopy is frequently performed on dedicated lists designed to optimise the throughput of patients. This could affect patient recall of clinical information with clinical, ethical and medicolegal consequences. The purpose of this study was to assess patient recall after knee arthroscopy and identify potential contributory factors.
Seventy-two patients undergoing day case knee arthroscopy were provided with information about their surgery post-operatively and tested for recall of the information prior to discharge. All patients underwent cognitive assessment when information was delivered and again when tested. Patient recall was correlated with demographic and anaesthetic factors and a multivariate regression model was used to identify risk factors for reduced recall.
Recall overall was poor. Significant independent risk factors for reduced recall were reduced cognitive state at the time of information delivery and a shorter time between surgery and information delivery. Duration of anaesthesia, use of sedatives and use of opiate analgesia were not significantly correlated with recall.
Information recall after day case knee athroscopy may be suboptimal. Allowing more time between surgery and information delivery may improve recall. However, this may be difficult during the course of a busy list and surgeons should consider using additional techniques to improve patient recall after surgery to reduce the risk of patient anxiety or non-compliance.
IV.
膝关节镜日间手术通常在专门设计的手术列表上进行,以优化患者的吞吐量。这可能会影响患者对临床信息的回忆,从而产生临床、伦理和法医学后果。本研究旨在评估膝关节镜检查后的患者记忆,并确定潜在的促成因素。
72 例行日间膝关节镜手术的患者在术后获得有关手术的信息,并在出院前对信息进行回忆测试。所有患者在信息传递时和测试时都进行认知评估。患者的回忆与人口统计学和麻醉因素相关,并使用多元回归模型确定记忆减退的危险因素。
总的来说,回忆情况较差。信息传递时认知状态降低和手术与信息传递之间的时间较短是记忆减退的显著独立危险因素。麻醉持续时间、使用镇静剂和使用阿片类镇痛药与回忆无显著相关性。
膝关节镜日间手术后的信息回忆可能不理想。增加手术与信息传递之间的时间间隔可能会改善回忆。然而,在繁忙的手术列表中可能会比较困难,因此外科医生应考虑使用其他技术来提高术后患者的记忆,以降低患者焦虑或不遵守医嘱的风险。
IV。