保护套的应用与减少气管插管期间的职业性焦虑有关：一项随机对照试验。
Application of a protective sleeve is associated with decreased occupational anxiety during endotracheal intubation: a randomized controlled trial.
机构信息
Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, People's Republic of China.
Cell-gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, No.600 Tianhe Road, Guangzhou, People's Republic of China.
出版信息
BMC Anesthesiol. 2021 Oct 22;21(1):251. doi: 10.1186/s12871-021-01467-7.
BACKGROUND
The high risk of cross-infection during tracheal intubation has caused excessive occupational anxiety for anaesthesiologists amid the novel coronavirus disease 2019 (COVID-19) pandemic. Currently, there is no effective way to attenuate their anxiety in clinical practice. We found that anaesthesiologist with better protective equipment might experience decreased levels of anxiety during intubation.
METHODS
In this study, 60 patients who underwent intubation and extubation in the operating room were enrolled, and then randomized 1:1 to either wear protective sleeves (protective sleeve group) or not (control group). Visual analogue scale (VAS) was used to measure the anxiety level of anaesthesiologists during intubation. The respiratory droplets of patients on the sleeve, and the anaesthesiologists' perception including the patient's oral malodour, exertion, satisfaction degree, waist discomfort and shoulder discomfort were recorded. The patients' anxiety, oppressed feelings and hypoxia and postoperative complications were all measured and recorded.
RESULTS
Compared with the control group, the anaesthesiologists in protective sleeve group achieved lower anxiety scores and better satisfaction degrees during the process of intubation and extubation (all P < 0.05). Respiratory droplets were observed only on the inner side, but not the external side, of the protective sleeves (P < 0.001). The incidence of the anaesthesiologists' perception of patients' oral malodour was significantly lower in the protective sleeve group (P = 0.02) and no patients developed hypoxemia or intubation-related complications in the protective sleeve group.
CONCLUSION
Using protective devices for intubation might eliminate droplet transmission from patients to anaesthesiologists, while also decreasing their anxiety in a controlled operating room environment.
TRIAL REGISTRATION
Chinese Clinical Trial. no. ChiCTR2000030705 . Registry at www.chictr.org.cn on 10/03/2020.
背景
新型冠状病毒病 2019（COVID-19）大流行期间，气管插管过程中交叉感染的高风险给麻醉师带来了过度的职业焦虑。目前，临床上尚无减轻其焦虑的有效方法。我们发现，使用防护设备更好的麻醉师在插管过程中可能会经历较低水平的焦虑。
方法
本研究纳入了 60 例在手术室进行插管和拔管的患者，随后以 1:1 的比例随机分为佩戴袖套（袖套组）或不佩戴袖套（对照组）。使用视觉模拟量表（VAS）测量麻醉师在插管过程中的焦虑水平。记录患者在袖套上的飞沫、麻醉师的感知，包括患者口腔异味、费力程度、满意度、腰部不适和肩部不适。测量并记录患者的焦虑、压抑感、缺氧和术后并发症。
结果
与对照组相比，袖套组的麻醉师在插管和拔管过程中焦虑评分更低，满意度更高（均 P<0.05）。只在袖套的内侧观察到飞沫，而不是外侧（P<0.001）。在袖套组中，麻醉师感知到患者口腔异味的发生率明显较低（P=0.02），且在袖套组中无患者发生低氧血症或与插管相关的并发症。
结论
在受控的手术室环境中，使用插管防护设备可能会消除患者向麻醉师飞沫传播，同时减轻他们的焦虑。
临床试验注册
中国临床试验注册中心，ChiCTR2000030705 ，于 2020 年 3 月 10 日在 www.chictr.org.cn 注册。
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