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术前远程咨询的质量:TELECAM 随机对照试验。

Quality of Preanesthesia Teleconsultation: The TELECAM Randomized Controlled Trial.

机构信息

Department of Anesthesia and Intensive Care, Promotion and Investigation, Lorraine University, CHRU-Nancy, Nancy, France.

Department of Methodology, Promotion and Investigation, Lorraine University, CHRU-Nancy, Nancy, France.

出版信息

Telemed J E Health. 2024 Aug;30(8):e2300-e2310. doi: 10.1089/tmj.2024.0027. Epub 2024 May 3.

Abstract

Preanesthesia teleconsultation helps reduce availability constraints as well as direct and indirect expenses. The TELECAM trial was performed to assess the quality of preanesthesia teleconsultation in terms of clinical parameters evaluation, feasibility, patient satisfaction and preoperative anxiety, and anesthesiologist satisfaction. TELECAM was an investigator-initiated, prospective, single-center, randomized, controlled, parallel group, evaluator-blinded, open-label study. Patients with a scheduled ambulatory surgery (orthopedic or hand surgery) were randomized into the in-person preanesthesia consultation group or the preanesthesia teleconsultation (conducted at the patient's home or workplace) group. The quality of the teleconsultation was evaluated through agreement on intubation difficulty, predictable mask ventilation difficulty, and American Society of Anesthesiologists (ASA) scores between the preanesthesia consultation and the preanesthesia in-person visit. A total of 241 patients were included, and 208 were considered in the analyses. The feasibility of teleconsultation was high, with a feasibility ratio of 87.5%. The quality of the preanesthesia consultation regarding the evaluation of predictable intubation, mask ventilation difficulties, and ASA score, did not differ between the two groups (p = 0.23, 0.29, and 0.06, respectively). The preoperative satisfaction was higher for patients who had a preanesthesia teleconsultation (p = 0.04). Patients' preoperative anxiety did not differ between the two groups (p = 0.90). The median satisfaction of the anesthesiologists who performed the teleconsultation reached a maximum of 10 (IQR: 8.0; 10.0). This study showed positive results for the quality of preanesthesia teleconsultation on the evaluation of clinical parameters, with high feasibility and satisfaction of the patients and anesthesiologists. The trial was registered in ClinicalTrials (NCT03470896).

摘要

术前远程咨询有助于减少可用性限制以及直接和间接费用。TELECAM 试验旨在评估术前远程咨询在临床参数评估、可行性、患者满意度和术前焦虑以及麻醉师满意度方面的质量。TELECAM 是一项由研究者发起的、前瞻性的、单中心的、随机的、对照的、平行组、评估者盲法、开放标签研究。计划进行门诊手术(骨科或手外科)的患者被随机分为面对面的术前咨询组或术前远程咨询(在患者家中或工作场所进行)组。通过比较术前咨询和术前面对面就诊时的插管难度、可预测的面罩通气难度和美国麻醉师协会(ASA)评分,评估远程咨询的质量。共纳入 241 例患者,其中 208 例纳入分析。远程咨询的可行性很高,可行性比例为 87.5%。在预测插管、面罩通气困难和 ASA 评分的评估方面,两组的术前咨询质量没有差异(p=0.23、0.29 和 0.06)。进行术前远程咨询的患者术前满意度更高(p=0.04)。两组患者术前焦虑无差异(p=0.90)。进行远程咨询的麻醉师的满意度中位数达到 10 分(IQR:8.0;10.0)。本研究显示,术前远程咨询在临床参数评估方面具有积极的效果,具有较高的可行性和患者及麻醉师的满意度。该试验已在 ClinicalTrials 注册(NCT03470896)。

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