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丹麦神经肌肉阻滞的客观神经肌肉监测:基于网络的当前实践调查。

Objective neuromuscular monitoring of neuromuscular blockade in Denmark: an online-based survey of current practice.

作者信息

Söderström C M, Eskildsen K Z, Gätke M R, Staehr-Rye A K

机构信息

Department of Anaesthesiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.

出版信息

Acta Anaesthesiol Scand. 2017 Jul;61(6):619-626. doi: 10.1111/aas.12907.

Abstract

BACKGROUND

Neuromuscular blocking agents are commonly used during general anaesthesia but can lead to postoperative residual neuromuscular blockade and associated morbidity. With appropriate objective neuromuscular monitoring (objNMM) residual blockade can be avoided. In this survey, we investigated the use of objNMM in Denmark.

METHODS

We conducted an anonymous Internet-based survey distributed through e-mails to Danish public anaesthesia departments. The survey consisted of 15-17 short questions regarding the use of objNMM.

RESULTS

A total of 653 (27%) anaesthetists from 90% of the hospitals answered the questionnaire. ObjNMM was always used by 58% of the anaesthetists and 86% used objNMM at least 75% of the times. Despite the frequent use, 75% of the anaesthetists experienced difficulties with objNMM in at least 25% of the cases. The likelihood of using objNMM was higher among nurse anaesthetists vs. anaesthesiologists (odds ratio (OR) 2.24 [95% confidence interval (CI): 1.62-3.08]), if the department had an employee with special interest in objNMM (OR 1.66 [95% CI: 1.12-2.47]), if the anaesthetist had < 5 years of experience (OR 1.88 [95% CI: 1.29-2.73]), or if experiencing difficulties with objNMM < 25% of the cases (OR 1.60 [95% CI: 1.00-2.57]).

CONCLUSION

In this survey, Danish anaesthetists frequently, in an international perspective, use objNMM, but the use is often associated with technical difficulties.

摘要

背景

神经肌肉阻滞剂在全身麻醉期间常用,但可导致术后残余神经肌肉阻滞及相关并发症。通过适当的客观神经肌肉监测(objNMM)可避免残余阻滞。在本次调查中,我们研究了丹麦objNMM的使用情况。

方法

我们通过电子邮件向丹麦公立麻醉科开展了一项基于互联网的匿名调查。该调查由15 - 17个关于objNMM使用情况的简短问题组成。

结果

来自90%医院的653名(27%)麻醉医生回答了问卷。58%的麻醉医生总是使用objNMM,86%的麻醉医生至少75%的时间使用objNMM。尽管使用频繁,但75%的麻醉医生在至少25%的病例中遇到过objNMM相关困难。与麻醉医师相比,麻醉护士使用objNMM的可能性更高(优势比(OR)2.24 [95%置信区间(CI):1.62 - 3.08]);如果科室有对objNMM特别感兴趣的员工(OR 1.66 [95% CI:1.12 - 2.47]);如果麻醉医生经验不足5年(OR 1.88 [95% CI:1.29 - 2.73]);或者如果在不到25%的病例中遇到objNMM相关困难(OR 1.60 [95% CI:1.00 - 2.57])。

结论

在本次调查中,从国际视角来看,丹麦麻醉医生经常使用objNMM,但使用过程中常伴有技术困难。

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