Sotirchos Vlasios S, Alexander Erica S, Zhao Ken, Zhan Chenyang, Yarmohammadi Hooman, Ziv Etay, Erinjeri Joseph P
Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, New York, United States.
J Clin Imaging Sci. 2024 Apr 11;14:11. doi: 10.25259/JCIS_9_2024. eCollection 2024.
In recent years, there has been increased utilization of monitored anesthesia care (MAC) in interventional radiology (IR) departments. The purpose of this study was to compare pre-procedure bed, procedure room, and post-procedure bed times for IR procedures performed with either nurse-administered moderate sedation (MOSED) or MAC.
An institutional review board-approved single institution retrospective review of IR procedures between January 2010 and September 2022 was performed. Procedures performed with general anesthesia or local anesthetic only, missing time stamps, or where <50 cases were performed for both MAC and MOSED were excluded from the study. Pre-procedure bed, procedure room, post-procedure bed, and total IR encounter times were compared between MAC and MOSED using the -test. The effect size was estimated using Cohen's d statistic.
97,480 cases spanning 69 procedure codes were examined. Mean time in pre-procedure bed was 27 min longer for MAC procedures (69 vs. 42 min, < 0.001, d = 0.95). Mean procedure room time was 11 min shorter for MAC (60 vs. 71 min, < 0.001, d = 0.48), and mean time in post-procedure bed was 10 min longer for MAC (102 vs. 92 min, < 0.001, d = 0.22). Total IR encounter times were on average 27 min longer for MAC cases (231 vs. 204 min, < 0.001, d = 0.41).
MAC improves the utilization of IR procedure rooms, but at the cost of increased patient time in the pre- and post-procedure areas.
近年来，介入放射科（IR）对监护麻醉（MAC）的使用有所增加。本研究的目的是比较采用护士实施的中度镇静（MOSED）或MAC进行IR手术时的术前病床、手术间和术后病床时间。
对2010年1月至2022年9月期间的IR手术进行了一项经机构审查委员会批准的单机构回顾性研究。排除了仅采用全身麻醉或局部麻醉、缺少时间戳记，或MAC和MOSED手术例数均少于50例的手术。使用t检验比较MAC和MOSED之间的术前病床、手术间、术后病床和IR总诊疗时间。使用Cohen's d统计量估计效应大小。
共检查了涵盖69个手术代码的97480例病例。MAC手术的术前病床平均时间长27分钟（69分钟对42分钟，P<0.001，d=0.95）。MAC的手术间平均时间短11分钟（60分钟对71分钟，P<0.001，d=0.48），MAC的术后病床平均时间长10分钟（102分钟对92分钟，P<0.001，d=0.22）。MAC病例的IR总诊疗时间平均长27分钟（231分钟对204分钟，P<0.001，d=0.41）。
MAC提高了IR手术室的利用率，但代价是患者在术前和术后区域的时间增加。
