特殊需求患者日间手术的安全性。

Safety of day surgery for patients with special needs.

机构信息

Department of Anaesthesiology and Critical Care, Rouen University Hospital, Rouen F-76000, France; Normandy University, UNIROUEN, Inserm U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication (DC2N), F-76000 Rouen, France.

Department of Anaesthesiology and Critical Care, Rouen University Hospital, Rouen F-76000, France.

出版信息

Anaesth Crit Care Pain Med. 2021 Dec;40(6):100949. doi: 10.1016/j.accpm.2021.100949. Epub 2021 Sep 16.

DOI:10.1016/j.accpm.2021.100949

PMID:34537388

Abstract

BACKGROUND

The objective of this study was to assess the safety and quality of day care management for dental surgery under general anaesthesia in a population with special needs and to compare the results with a control population.

METHODS

A retrospective observational cohort study was performed. The study population included all patients who had day care dental surgery under general anaesthesia for one year. The primary endpoint was the rate of unscheduled admission, which was defined as the unplanned need to maintain a hospital stay on the evening of the surgical procedure. Secondary endpoints included occurrence of complications during the perioperative period (either anaesthesia or surgery related) on the day of surgery (D0) and on day 1 and satisfaction of patients or their relatives.

RESULTS

Data from 138 patients (70 with special needs and 68 controls) were analysed. In both groups, patients were young (mean age 33 years ± 14 in each group). Special needs were mainly related to autism (34%), cerebral palsy (19%), intellectual disability (19%) and Down syndrome (10 %). Surgical procedures were more extensive in the control group. There was 1 unscheduled admission in the special needs group and 3 in the control group (RR 0.32, 95% CI [0.03; 3.04]). There was no difference in the rate of complications.

CONCLUSION

In our cohort, day care management for dental surgery under general anaesthesia is safe and effective for patients with special needs.

摘要

背景

本研究旨在评估全麻下日间牙科手术管理在特殊需求人群中的安全性和质量，并与对照组进行比较。

方法

回顾性观察队列研究。研究人群包括所有接受全麻日间牙科手术的患者。主要终点是计划性入院率，定义为手术当晚需要计划外住院的情况。次要终点包括手术当天（D0）和第 1 天围手术期（麻醉或手术相关）并发症的发生情况，以及患者或其家属的满意度。

结果

分析了 138 例患者（70 例有特殊需求，68 例为对照组）的数据。两组患者均较年轻（平均年龄分别为 33 岁±14 岁）。特殊需求主要与自闭症（34%）、脑瘫（19%）、智力障碍（19%）和唐氏综合征（10%）有关。对照组的手术程序更为广泛。特殊需求组有 1 例计划性入院，对照组有 3 例（RR 0.32，95%CI [0.03; 3.04]）。并发症发生率无差异。