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实践中的精准性:一项关于地氟烷和七氟烷低流量麻醉技术以实现经济高效且可持续医疗护理的审计研究。

Precision in practice: An audit study on low-flow anesthesia techniques with desflurane and sevoflurane for cost-effective and sustainable care.

作者信息

Chowdappa Gopinath Kenkare, Iolov Svetoslav Ivanov, Abuamra Khaled Saleh, Kulkarni Prasad Padmakar, Shariff Jameelulla Aleemulla, Abdelaziz Hatem Mohammed Khairy, Kumar Justin Arun

机构信息

Department of Anesthesia, Dubai Hospital, Al Baraha, Dubai, UAE.

出版信息

Saudi J Anaesth. 2024 Jul-Sep;18(3):388-394. doi: 10.4103/sja.sja_142_24. Epub 2024 Jun 4.

Abstract

INTRODUCTION

In the backdrop of escalating healthcare costs and an increasing focus on resource optimization, this audit study delves into the realm of anesthesia management, specifically exploring the application of low-flow anesthesia (LFA). The primary objective was to assess adherence to hospital standards and evaluate the economic implications of LFA (<1 L/min).

MATERIALS AND METHODS

This retrospective audit focused on 700 adult patients undergoing elective surgeries with general anesthesia. Data sources included anesthesia records, electronic recording systems, and audits by a dedicated team. Fresh gas flow rates (FGFRs), minimum alveolar concentration (MAC), and volatile anesthetic consumption were analyzed. Cost comparisons between low-flow and high-flow anesthesia were conducted, employing specific cost per milliliter metrics.

RESULTS

The average FGFR during the maintenance phase was found to be 0.45 ± 0.88 L/min. Adherence to hospital standards was notably high, with 94.29% of patients being maintained on low-flow gas rates. The differences in anesthetic consumption between low-flow and high-flow FGFR were statistically significant for both desflurane (12.17 ± 10.84 ml/MAC hour versus 43.12 ± 27.25 ml/MAC hour) and sevoflurane (3.48 ± 7.22 ml/MAC hour versus 5.20 ± 5.20 ml/MAC hour, < 0.001). The calculated savings per patient with low-flow desflurane and sevoflurane anesthesia compared to high flow were found to be 109.25 AED and 6.74 AED, respectively.

CONCLUSION

This audit advocates for the widespread adoption of LFA as a standard practice. Beyond aligning with hospital standards, the study highlights the multi-faceted benefits of LFA, encompassing economic savings, environmental safety, and enhanced patient care.

摘要

引言

在医疗成本不断攀升以及对资源优化的关注度日益提高的背景下,本审计研究深入探讨麻醉管理领域,特别探究低流量麻醉(LFA)的应用。主要目标是评估对医院标准的遵守情况,并评估低流量麻醉(<1升/分钟)的经济影响。

材料与方法

这项回顾性审计聚焦于700例接受全身麻醉的择期手术成年患者。数据来源包括麻醉记录、电子记录系统以及由专门团队进行的审计。分析了新鲜气体流速(FGFR)、最低肺泡浓度(MAC)和挥发性麻醉剂消耗量。采用每毫升特定成本指标对低流量麻醉和高流量麻醉进行成本比较。

结果

维持期的平均FGFR为0.45±0.88升/分钟。对医院标准的遵守情况显著较高,94.29%的患者维持在低流量气体速率。对于地氟烷(12.17±10.84毫升/ MAC小时对43.12±27.25毫升/ MAC小时)和七氟烷(3.48±7.22毫升/ MAC小时对5.20±5.20毫升/ MAC小时,<0.001),低流量和高流量FGFR之间的麻醉剂消耗量差异具有统计学意义。与高流量相比,低流量地氟烷和七氟烷麻醉每位患者计算得出的节省分别为109.25阿联酋迪拉姆和6.74阿联酋迪拉姆。

结论

本审计提倡广泛采用LFA作为标准做法。除了符合医院标准外,该研究还强调了LFA的多方面益处,包括经济节省、环境安全和改善患者护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddda/11323908/dffcd1c5e71a/SJA-18-388-g001.jpg

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