Kelly Sarah M, Quenby Miranda, Corcoran Tomás B, Webb Steven, Cohen Paul A
Obstetrics and Gynaecology National Maternity Hospital Dublin Ireland.
St John of God Subiaco Hospital Perth Western Australia Australia.
Health Sci Rep. 2023 Jun 14;6(6):e1335. doi: 10.1002/hsr2.1335. eCollection 2023 Jun.
Adequate postoperative analgesia and prevention of post-op nausea and vomiting (PONV) are core components of modern day anaesthesia and peri-operative care. As well as contributing to overall morbidity, postoperative pain and PONV are frequently cited as one of the most unpleasant and distressing aspects of surgery for patients. Variation in healthcare delivery is known to exist but has often been poorly described. A first step to understanding the consequences of variation is to describe the extent of variation. We aimed to assess variation in pharmacological strategies to prevent postoperative pain, nausea and vomiting in patients undergoing elective major abdominal surgery at a tertiary hospital in Perth, Western Australia, over a three-month period.
Retrospective cross-sectional study.
We observed considerable variation in prescribing of postoperative analgesia and PONV prophylaxis and suggest that despite adequate evidence based guidelines, they are often overlooked in practice.
Measurement of the consequences of variation requires randomised clinical trials that evaluate differences in outcome and cost, associated with the strategies that exist within the spectrum of variation.
充分的术后镇痛以及预防术后恶心呕吐（PONV）是现代麻醉和围手术期护理的核心组成部分。术后疼痛和PONV不仅会导致总体发病率增加，还经常被认为是患者手术中最不愉快和痛苦的方面之一。已知医疗服务存在差异，但往往描述得不够充分。理解差异后果的第一步是描述差异程度。我们旨在评估西澳大利亚州珀斯一家三级医院在三个月期间，对接受择期腹部大手术患者预防术后疼痛、恶心和呕吐的药物治疗策略的差异。
回顾性横断面研究。
我们观察到术后镇痛和PONV预防用药存在显著差异，并表明尽管有充分的循证指南，但在实践中它们常常被忽视。
对差异后果的衡量需要进行随机临床试验，以评估与差异范围内存在的策略相关的结局和成本差异。
