Shirane Shogo, Funakoshi Hiraku, Takahashi Jin, Homma Yosuke, Norii Tatsuya
Department of Emergency and Critical Care Medicine Tokyobay Urayasu Ichikawa Medical Center Chiba Japan.
Department of Emergency Medicine Chiba Kaihin Municipal Hospital Chiba Japan.
Acute Med Surg. 2023 Oct 27;10(1):e901. doi: 10.1002/ams2.901. eCollection 2023 Jan-Dec.
Capnography is recommended for use in procedural sedation and analgesia (PSA); however, limited studies assess its impact on recovery time. We investigated the association between capnography and the recovery time of PSA in the emergency department (ED).
This study was a secondary analysis of a multicenter PSA patient registry including eight hospitals in Japan. We included all patients who received PSA in the ED between May 2017 and May 2021 and divided the patients into capnography and no-capnography groups. The primary outcome was recovery time, defined as the time from the end of the procedure to the cessation of monitoring. The log-rank test and multivariable analysis using clustering for institutions were performed.
Of the 1265 screened patients, 943 patients who received PSA were enrolled and categorized into the capnography ( = 150, 16%) and no-capnography ( = 793, 84%) groups. The median recovery time was 40 (interquartile range [IQR]: 25-63) min in the capnography group and 30 (IQR: 14-55) min in the no-capnography group. In the log-rank test, the recovery time was significantly longer in the capnography group ( = 0.03) than in the no-capnography group. In the multivariable analysis, recovery time did not differ between the two groups (adjusted hazard ratio, 0.95; 95% confidence interval, 0.77-1.17; = 0.61).
In this secondary analysis of the multicenter registry of PSA in Japan, capnography use did not associate with shorter recovery time in the ED.
推荐在程序性镇静镇痛(PSA)中使用二氧化碳监测;然而,评估其对恢复时间影响的研究有限。我们调查了急诊室(ED)中二氧化碳监测与PSA恢复时间之间的关联。
本研究是对一个包括日本八家医院的多中心PSA患者登记处的数据进行的二次分析。我们纳入了2017年5月至2021年5月期间在ED接受PSA的所有患者,并将患者分为二氧化碳监测组和无二氧化碳监测组。主要结局是恢复时间,定义为从手术结束到停止监测的时间。进行了对数秩检验和使用机构聚类的多变量分析。
在1265名筛查患者中,943名接受PSA的患者被纳入并分为二氧化碳监测组(n = 150,16%)和无二氧化碳监测组(n = 793,84%)。二氧化碳监测组的中位恢复时间为40(四分位间距[IQR]:25 - 63)分钟,无二氧化碳监测组为30(IQR:14 - 55)分钟。在对数秩检验中,二氧化碳监测组的恢复时间显著长于无二氧化碳监测组(P = 0.03)。在多变量分析中,两组之间的恢复时间没有差异(调整后的风险比,0.95;95%置信区间,0.77 - 1.17;P = 0.61)。
在这项对日本PSA多中心登记处的二次分析中,在ED中使用二氧化碳监测与较短的恢复时间无关。