Thomas Jefferson University Hospital, Department of Otolaryngology-Head and Neck Surgery, 925 Chestnut St, Philadelphia, PA 19107, United States of America.
Thomas Jefferson University Hospital, Department of Otolaryngology-Head and Neck Surgery, 925 Chestnut St, Philadelphia, PA 19107, United States of America.
Am J Otolaryngol. 2022 Jul-Aug;43(4):103483. doi: 10.1016/j.amjoto.2022.103483. Epub 2022 May 4.
To compare the experiences of patients who received sialendoscopy under general anesthesia (GA) with those who received monitored anesthesia care (MAC).
Patients who underwent sialendoscopy for sialadenitis or sialolithiasis from July 1, 2020, to July 31, 2021, were offered inclusion to this prospective observational study. A survey was sent to consenting patients on post-operative day 1 to record aspects of their pre-, intra-, and post-operative experience. The primary outcome was overall satisfaction. Secondary outcomes included pain tolerability and preference for similar anesthetic modality in the future.
Seventy-five patients completed the post-operative survey (86% response rate), of which 39 patients received GA and 36 received MAC. Patient overall satisfaction was similar between groups (GA: "Poor/Average/Good" = 23%, "Excellent" = 77%; MAC: "Poor/Average/Good" = 25%, "Excellent" = 75%, p = 1.00). Tolerability of immediate post-operative pain was likewise similar between the GA (82%) and MAC (97%) groups (p = 0.058). Patients who received MAC reported intra-operative pain as "none/tolerable" 72% of the time and "uncomfortable" 28% of the time. Patients who received GA would prefer the same anesthetic in the future more often than in the MAC group (85% versus 61%, respectively, OR 3.50, 95% CI 1.17-10.50, p = 0.035).
In regard to patient satisfaction, both MAC and GA are acceptable anesthetic choices in sialendoscopy for appropriate cases. Patients report similar overall satisfaction and post-operative pain tolerance under either anesthetic modality. Patients who undergo GA report higher rates of preference for similar anesthetic modality in the future. Further study is needed to determine the most appropriate criteria for anesthesia modality selection.
比较全身麻醉（GA）和监测下麻醉管理（MAC）下接受涎腺镜检查的患者的体验。
本前瞻性观察研究纳入了 2020 年 7 月 1 日至 2021 年 7 月 31 日期间因涎腺炎或涎石病接受涎腺镜检查的患者。术后第 1 天，向同意参与的患者发送了一份调查问卷，以记录其术前、术中及术后体验的各个方面。主要结局是总体满意度。次要结局包括疼痛耐受性和对未来类似麻醉方式的偏好。
75 例患者完成了术后调查（86%的应答率），其中 39 例接受 GA，36 例接受 MAC。两组患者的总体满意度相似（GA：“差/一般/好”=23%，“优”=77%；MAC：“差/一般/好”=25%，“优”=75%，p=1.00）。GA（82%）和 MAC（97%）组患者术后即刻疼痛耐受性也相似（p=0.058）。接受 MAC 的患者术中疼痛有 72%的时间报告为“无/可耐受”，28%的时间报告为“不适”。接受 GA 的患者在未来更倾向于选择相同的麻醉方式，而不是 MAC 组（分别为 85%和 61%，OR 3.50，95%CI 1.17-10.50，p=0.035）。
在患者满意度方面，对于合适的病例，MAC 和 GA 都是可接受的麻醉选择。两种麻醉方式下，患者的总体满意度和术后疼痛耐受性相似。接受 GA 的患者报告未来更倾向于选择相同的麻醉方式。需要进一步研究以确定最合适的麻醉方式选择标准。
