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术前教育可提高全身麻醉苏醒时拔管的准备程度!

Preoperative education improves the preparedness for extubation at emergence from general anaesthesia!

作者信息

Sameen Zaka, Talib Khan, Wani Shaqul Q, Ashraf Muntasir, Nengroo Showkat H

机构信息

Department of Anaesthesiology, Pain and Critical Care, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India.

Division of Cardiovascular and Thoracic Anaesthesia and Cardiac Surgical Intensive Care, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India.

出版信息

J Perioper Pract. 2022 Mar;32(3):41-46. doi: 10.1177/1750458920936213. Epub 2020 Jul 10.

Abstract

BACKGROUND

Preoperative patient education is an essential responsibility of any healthcare provider, especially an anaesthetist, and is beneficial for perioperative outcome. A smooth emergence and extubation is a clinical skill that needs to be mastered by an anaesthetist. The aim of this study was to analyse whether a detailed preoperative patient education improves the quality of and preparedness for extubation at emergence from general anaesthesia.

METHODS

One hundred patients were randomly assigned to two groups. The study group received a detailed preoperative patient education and counselling about the mode of anaesthesia, extubation process and their expected response at extubation while the control group received the routine counselling. The Extubation Quality Scale at emergence and the recovery profile in the post anaesthesia care unit were assessed for both groups.

RESULTS

The primary outcome was a better quality of extubation in the patients who received a detailed preoperative patient education. The Extubation Quality Scale was found to be better for patients in the study group (p < 0.001). The endotracheal tube tolerance at a minimum alveolar concentration of ≤0.2 and response to verbal commands at extubation were better for the study group (p < 0.05) besides an earlier discharge from post anaesthesia care unit (p < 0.005).

CONCLUSION

Preoperative patient education improves the patients' preparedness for and quality of extubation and recovery from general anaesthesia.

摘要

背景

术前患者教育是任何医疗保健提供者的一项重要职责,尤其是麻醉医生,且对围手术期结局有益。平稳的苏醒和拔管是麻醉医生需要掌握的一项临床技能。本研究的目的是分析详细的术前患者教育是否能提高全身麻醉苏醒时拔管的质量和准备情况。

方法

100例患者被随机分为两组。研究组接受了关于麻醉方式、拔管过程及其在拔管时预期反应的详细术前患者教育和咨询,而对照组接受常规咨询。对两组患者在苏醒时的拔管质量量表及麻醉后护理单元的恢复情况进行评估。

结果

主要结局是接受详细术前患者教育的患者拔管质量更好。发现研究组患者的拔管质量量表得分更高(p < 0.001)。除了从麻醉后护理单元更早出院(p < 0.005)外,研究组在最低肺泡浓度≤0.2时的气管导管耐受性及拔管时对言语指令的反应也更好(p < 0.05)。

结论

术前患者教育可提高患者对全身麻醉拔管及苏醒的准备程度和质量。

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