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采用专门的脊柱团队方法优化手术室 (OT) 效率,同时保持青少年特发性脊柱侧凸 (AIS) 手术的标准化患者护理:一个专业的脊柱单位经验。

Optimising operating theatre (OT) efficiency while maintaining the standardised patient care in adolescent idiopathic scoliosis (AIS) surgery with the dedicated spine team approach: a specialised spine unit experience.

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Universiti Malaya, 50603, Kuala Lumpur, Malaysia.

Department of Anesthesiology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.

出版信息

Eur Spine J. 2024 Oct;33(10):3806-3813. doi: 10.1007/s00586-024-08352-0. Epub 2024 Jun 11.

Abstract

PURPOSE

To report the efficiency of OT utilisation and perioperative outcomes with a dedicated spine team approach in AIS patients who underwent posterior spinal fusion (PSF) surgeries in a consecutive case operation list.

METHODS

Three AIS patients operated in a day (8:00 AM-8:00 PM) by a dedicated spine team were recruited between 2021 and 2022. The dedicated team comprised of three senior spine consultants who operated using a dual attending surgeon strategy, an anaesthetic consultant, dedicated surgical scrub nurses, anaesthesiology nurses, radiographers, and neuromonitoring technicians. Patients were categorised according to the sequence of operation list of the day (Case 1, Case 2, and Case 3). OT efficiency was represented by OT time in five stages (preoperative time, operative time, postoperative time, total OT time, and turnover time). OT time and perioperative outcomes were compared.

RESULTS

102 cases were analysed. On average, Case 1 began at 8:38 AM whereas Case 3 ended by 5:54 PM. OT efficiency was consistent throughout the day of operation with comparable OT time in all five stages between groups (p > 0.05). The mean turnover time was 15.1 ± 13.5 min and the mean operative time was 123.0 ± 28.1 min. Intraoperative arterial blood gas (ABG) parameters were maintained in an optimal range. The complication rate was 2.0% (N = 2/102).

CONCLUSION

Consistent OT efficiency was demonstrated with a dedicated spine team approach. Despite performing three AIS cases in a consecutive case operation list, patients' safety was not compromised as perioperative outcomes between groups were comparable.

摘要

目的

报告在连续病例手术清单中,通过专门的脊柱团队方法对接受后路脊柱融合(PSF)手术的 AIS 患者的 OT 使用效率和围手术期结果。

方法

2021 年至 2022 年期间,招募了每天(上午 8 点至晚上 8 点)由专门脊柱团队进行手术的 3 名 AIS 患者。专门团队由三名资深脊柱顾问组成,他们采用双主治医生策略进行手术,包括一名麻醉顾问、专门的手术刷手护士、麻醉护士、放射技师和神经监测技术人员。患者根据当天手术清单的顺序进行分类(病例 1、病例 2 和病例 3)。OT 效率用五个阶段的 OT 时间来表示(术前时间、手术时间、术后时间、总 OT 时间和交接时间)。比较 OT 时间和围手术期结果。

结果

分析了 102 例病例。平均而言,病例 1 于上午 8:38 开始,而病例 3 于下午 5:54 结束。手术日当天的 OT 效率保持一致,各组五个阶段的 OT 时间相当(p>0.05)。平均交接时间为 15.1±13.5 分钟,平均手术时间为 123.0±28.1 分钟。术中动脉血气(ABG)参数保持在最佳范围。并发症发生率为 2.0%(N=102)。

结论

专门的脊柱团队方法表现出一致的 OT 效率。尽管在连续病例手术清单中完成了 3 例 AIS 病例,但患者的安全性并未受到影响,因为各组之间的围手术期结果相当。

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