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远程麻醉咨询与现场咨询在儿童镇静磁共振成像检查中的质量比较:一项随机对照试验。

Quality comparison of remote anesthetic consultation versus on-site consultation in children with sedation for a magnetic resonance imaging examination-A randomized controlled trial.

机构信息

Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Germany.

Department of Anesthesiology, Hospital Andernach, Germany.

出版信息

Paediatr Anaesth. 2023 Aug;33(8):647-656. doi: 10.1111/pan.14679. Epub 2023 Apr 17.

Abstract

BACKGROUND

In the course of the corona pandemic, digital media has increasingly been used in many areas of medical practice to reduce personal contact. As it is of interest whether this can be practiced in the context of anesthesia consultations without loss of quality, we interviewed parents whose children received a cardiac or neuro magnetic resonance imaging (MRI) under sedation. Parents either received an on-site or a remote consultation conducted by an anesthesiologist. Both parents and anesthesiologist were asked to indicate their satisfaction with the respective consultation procedure in a questionnaire.

AIM

The aim of this study was to investigate if remote pre-anesthesia consultation, supported by an online video, for parents whose children are receiving MRI examinations under sedation can replace the commonly performed on-site consultation, without decreasing its quality.

METHODS

In this randomized trial, a total of 200 patients were included, one half received pre-anesthesia consultation on-site and the other half was given a link to a video and pre-anesthesia consultation was conducted by phone. As a primary analysis, we compared the level of satisfaction for the general procedure, the quality of the pre-anesthesia consultation and the contact to the anesthesiologists (or parents). We further investigated the frequency of complications and the preference for a possible next informed consent.

RESULTS

Both groups showed high levels of satisfaction. Some anesthesiologists and parents were less satisfied with the quality of on-site pre-anesthesia consultation than with the remote. In our patient cohort, there was no evidence for higher risk of complications when information was provided by telephone. Further, parents as well as anesthesiologists clearly favored the combined form of telephone information and online video. Overall, 61.2% of parents and 64% of anesthesiologists would choose this form of pre-anesthesia consultation for repeat anesthesia.

CONCLUSIONS

We did not observe that combined telephone and video decreased the quality of pre-anesthesia consultation. A remote version seems feasible for simple procedures such as sedation for MRI. Further research on this topic in other areas of anesthesia would be beneficial.

摘要

背景

在冠状病毒大流行期间,数字媒体已在医学实践的许多领域被越来越多地使用,以减少人际接触。由于人们对在麻醉咨询中是否可以在不降低质量的情况下进行这种操作感兴趣,我们采访了接受镇静下心脏或神经磁共振成像(MRI)检查的儿童的家长。家长接受了麻醉师现场或远程咨询。家长和麻醉师都被要求在问卷中表明他们对各自咨询过程的满意度。

目的

本研究旨在调查远程麻醉前咨询,通过在线视频支持,是否可以替代通常进行的现场咨询,而不会降低其质量,从而为接受镇静下 MRI 检查的儿童的家长提供服务。

方法

在这项随机试验中,共纳入 200 名患者,其中一半接受现场麻醉前咨询,另一半则提供视频链接,并通过电话进行麻醉前咨询。作为主要分析,我们比较了一般程序、麻醉前咨询质量以及与麻醉师(或家长)的联系的满意度。我们进一步调查了并发症的频率以及对可能的下一次知情同意的偏好。

结果

两组都表现出很高的满意度。一些麻醉师和家长对现场麻醉前咨询的质量不满意,而对远程咨询的质量满意。在我们的患者队列中,通过电话提供信息时没有证据表明并发症风险更高。此外,家长和麻醉师都明显倾向于电话信息和在线视频相结合的形式。总的来说,61.2%的家长和 64%的麻醉师会选择这种麻醉前咨询形式用于重复麻醉。

结论

我们没有观察到联合电话和视频会降低麻醉前咨询的质量。对于简单的程序,如镇静下的 MRI,远程版本似乎是可行的。在其他麻醉领域对此主题进行进一步研究将是有益的。

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