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中国三级妇产和儿童医院非侵入性操作的镇静现状:5 年更新。

Current sedation practices for non-invasive procedures in tertiary maternity and children's hospitals in China: a 5-year update.

机构信息

Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, Shanghai, China.

Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, Shanghai, China

出版信息

BMJ Paediatr Open. 2024 Oct 30;8(1):e002415. doi: 10.1136/bmjpo-2023-002415.

Abstract

BACKGROUND

Sedation techniques can ease anxiety during medical procedures for children. Our previous report on Chinese sedation practices for non-invasive procedures in 2018 is outdated due to the rapid development of sedation services. This study provides an updated report on sedation practices for non-invasive procedures in China.

METHODS

This is a cross-sectional study. Questionnaires were sent to tertiary maternity and children's hospitals nationwide through the WeChat Mini Program. The survey questioned the location and caseloads of hospitals providing sedation services, support facilities, contraindications, fasting practices, sedation regimens, monitoring practices, staff structure, certification requirements for sedation providers and quality control data.

RESULTS

Procedural sedation for non-invasive procedures were provided in 88 of 114 hospitals. These hospitals are located across the country except Heilongjiang province and the Tibet Autonomous Region. Compared with previous reports, significant increases were found in the number of hospitals providing sedation services, dedicated sedation rooms and recovery rooms and full-time sedation providers. Most hospitals advocated the 2-4-6 rule for pre-sedation fasting. Dexmedetomidine was the most used first-choice sedative. Anaesthesiologists remain the primary sedation providers, but nurses are also important. The most mentioned qualification requirements for sedation providers were a professional title of attending doctor, ≥5 years of working experience in paediatric anaesthesia and paediatric advanced life support certification. Sedation service records were used in 83 hospitals, but only 42 and 39 recorded success rates and adverse events, respectively.

CONCLUSIONS

Sedation services for non-invasive procedures are available in most areas of China. More hospitals now provide sedation services and full-time sedation providers. Supporting facilities and sedation regimens have improved. Non-anaesthesiologist sedation providers are important at current stage, developing training programmes for them may be necessary. Attention should be focused on quality control and improvement of sedation services.

摘要

背景

镇静技术可以缓解儿童在接受非侵入性医疗程序时的焦虑。我们之前在 2018 年报告的中国非侵入性程序镇静实践已经过时,因为镇静服务的快速发展。本研究提供了中国非侵入性程序镇静实践的最新报告。

方法

这是一项横断面研究。通过微信小程序向全国三级妇产儿童医院发送问卷。该调查询问了提供镇静服务的医院的位置和病例量、支持设施、禁忌症、禁食实践、镇静方案、监测实践、人员结构、镇静提供者的认证要求和质量控制数据。

结果

88 家 114 家医院提供非侵入性程序的镇静。这些医院分布在全国各地,除了黑龙江省和西藏自治区。与之前的报告相比,提供镇静服务的医院数量、专用镇静室和恢复室以及全职镇静提供者显著增加。大多数医院提倡 2-4-6 规则的术前禁食。右美托咪定是最常用的首选镇静剂。麻醉医师仍然是主要的镇静提供者,但护士也很重要。提到最多的镇静提供者资格要求是主治医生职称、5 年以上小儿麻醉工作经验和儿科高级生命支持认证。83 家医院使用镇静服务记录,但只有 42 家和 39 家分别记录了成功率和不良事件。

结论

中国大部分地区都提供非侵入性程序的镇静服务。现在有更多的医院提供镇静服务和全职镇静提供者。支持设施和镇静方案得到了改善。非麻醉医师的镇静提供者在现阶段很重要,可能需要为他们制定培训计划。应关注镇静服务的质量控制和改进。

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