Hong B, Baker A
Oral and Maxillofacial Surgery Department, Musgrove Park Hospital, Taunton, TA1 5DA.
Br Dent J. 2017 Feb 24;222(4):261-267. doi: 10.1038/sj.bdj.2017.171.
The case selection for adult dental extraction under general anaesthesia (GA) is inevitably subjective. A culture of overprescription has implications for patient safety as well as for the limited resources of the National Health Service. We explored the current perceptions and opinions of clinicians in oral and maxillofacial surgery (OMFS) units throughout the UK on various aspects of adult dental extraction under general anaesthesia (DGA) service. An email with an electronic survey link was sent to members of the British Association of Oral and Maxillofacial Surgeons and postgraduate dental deaneries. An institutional response rate of 67.3% was reached (241 clinicians of varying grades from 107 out of 159 oral and maxillofacial surgery units in the UK). There was a general consensus that the culture of demand-driven adult DGA exists and needs to be addressed. However, opinions were divided and varied on how this could be achieved. A small majority (58.1%) were in favour of adult DGA guidelines and this group provided suggestions for selection criteria. Those that did not feel such guidelines would improve the situation were pessimistic of the potential for change in patients' attitude towards DGA. This group cited the poor adherence to other existing guidelines, or suggested alternative ideas to guidelines.
全身麻醉下成人拔牙病例的选择不可避免地带有主观性。过度开药的风气不仅对患者安全有影响,也会影响国民医疗服务体系有限的资源。我们探讨了英国各地口腔颌面外科(OMFS)科室的临床医生对全身麻醉下成人拔牙(DGA)服务各方面的当前看法和意见。一封带有电子调查问卷链接的电子邮件被发送给了英国口腔颌面外科医生协会的成员和牙科研究生学院。机构回应率达到了67.3%(来自英国159个口腔颌面外科科室中107个科室的241名不同职级的临床医生)。普遍的共识是,需求驱动的成人DGA风气存在且需要得到解决。然而,对于如何实现这一点,意见存在分歧且各不相同。一小部分多数人(58.1%)支持成人DGA指南,这一组提供了选择标准的建议。那些认为此类指南不会改善情况的人对患者对DGA态度改变的可能性持悲观态度。这一组提到对其他现有指南的遵守情况不佳,或者提出了指南以外的其他想法。