Komasawa Nobuyasu, Fujiwara Shunsuke, Atagi Kazuaki, Ueki Ryusuke, Haba Masanori, Ueshima Hironobu, Kaminoh Yoshiroh, Minami Toshiaki
Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsukishi, Osaka, 569-8686, Japan,
J Anesth. 2014 Oct;28(5):785-9. doi: 10.1007/s00540-014-1787-9. Epub 2014 Jan 18.
The purpose of this study was to conduct a survey of emergency or complication during sedation and change of attitude toward sedation by simulation-based sedation training course (SEDTC) hosted by the Japanese Association of Medical Simulation. We used a questionnaire survey to non-anesthesiologists who participated in the 1st to 13th SEDTCs from 2011 to 2012. Survey contents included emergencies or complications during sedation and impressions of the Sedation and Analgesia guidelines for non-anesthesia doctors developed by the American Society of Anesthesiologists. Of 84 non-anesthesiologists, 81 have encountered patient respiratory suppression. More than 70% non-anesthesiologists have encountered patient respiratory arrest. All non-anesthesiologists have encountered patient cardiac suppression; 20-30% of non-anesthesiologists have encountered patient anaphylaxis, asthma attack, and cardiac arrest; and all non-anesthesiologists have encountered patient vomiting and about 80% aspiration. Non-anesthesiologists largely accepted the guidelines. SEDTC attendance improved significantly 13 points of 18 important suggestions. As non-anesthesiologists experience several complications during sedation, SEDTC may be useful for the improvement of their attitude toward the safety management of sedation.
本研究旨在通过日本医学模拟协会主办的基于模拟的镇静培训课程（SEDTC），对镇静期间的紧急情况或并发症进行调查，并改变对镇静的态度。我们对2011年至2012年参加第1至13期SEDTC的非麻醉医生进行了问卷调查。调查内容包括镇静期间的紧急情况或并发症，以及美国麻醉医师协会制定的非麻醉医生镇静与镇痛指南的印象。在84名非麻醉医生中，81人遇到过患者呼吸抑制。超过70%的非麻醉医生遇到过患者呼吸骤停。所有非麻醉医生都遇到过患者心脏抑制；20%-30%的非麻醉医生遇到过患者过敏反应、哮喘发作和心脏骤停；所有非麻醉医生都遇到过患者呕吐，约80%遇到过误吸。非麻醉医生在很大程度上接受了这些指南。参加SEDTC后，18条重要建议中有13条得到了显著改善。由于非麻醉医生在镇静期间经历了多种并发症，SEDTC可能有助于改善他们对镇静安全管理的态度。
