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欧洲的麻醉实践:欧洲麻醉与重症监护学会国家麻醉医师协会委员会的一项调查

Anaesthesia practice in Europe: A survey of the National Anaesthesiologists Societies Committee of the European Society of Anaesthesiology and Intensive Care.

作者信息

Pinelli Fulvio, Romagnoli Stefano, Singh Sweta, Albaladejo Pierre, Nau Carla, Bilotta Federico

机构信息

From the Department of Anaesthesia and Intensive Care, Azienda Ospedaliera Universitaria Careggi (FP, SR), Department of Health Science, University of Florence, Florence (SR), Department of Anaesthesia and Intensive Care, Università La Sapienza, Rome, Italy (SS, FB), Department of Anaesthesia and Intensive Care, Grenoble Alpes University, Grenoble, France (PA) and Department of Anaesthesia and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (CN).

出版信息

Eur J Anaesthesiol. 2025 Mar 1;42(3):189-202. doi: 10.1097/EJA.0000000000002110. Epub 2024 Dec 16.

Abstract

BACKGROUND

Similar to other continents, Europe is experiencing a shortage of anaesthesia workforce, which profoundly impacts the national healthcare systems of affected countries.

OBJECTIVE

To assess the current landscape of the anaesthesia workforce, organisational practices, rules and responsibilities of anaesthesiologists and other anaesthesia providers in operating rooms.

DESIGN

Survey.

SETTING

Thirty-nine out of 41 European countries were surveyed between April 2022 and April 2023.

PARTICIPANTS

Delegates of the National Anaesthesiologists Societies Committee (NASC) of the European Society of Anaesthesiology and Intensive Care (ESAIC).

INTERVENTION

A faculty of experts from France, Germany and Italy, selected by the Chair of NASC, developed a survey consisting of 16 questions, which was sent to the NASC delegates of all European countries.

MAIN OUTCOME MEASURES

Responses from the NASC delegates.

RESULTS

The anaesthesia workforce, composition, roles and duties of anaesthesia teams vary significantly among European countries. The majority of respondents reported a workforce shortage, with variable trends, exacerbated in some cases by an increased loss of anaesthesiologists following the COVID-19 pandemic. Significant differences in anaesthesiologists' salaries exist across countries. A one-to-one anaesthesiologist-to-patient ratio during general anaesthesia maintenance, neuraxial and peripheral blocks is the most common; however, in a notable number of cases, this ratio decreases to one-to-two or even less. In such instances, residents or nonphysician anaesthesia personnel (NPAs) play a crucial role, enabling anaesthesiologists to supervise more than one patient simultaneously. Differences in the training of anaesthesia team members, as well as rules regulating anaesthesia team composition and the autonomy of its members, were also evident.

CONCLUSION

The survey provides data on the current anaesthesia practice in Europe. The availability, composition and organisation of anaesthesia team members differ among European countries. The study highlights areas for further focus in operating room organisation and anaesthesia team composition, particularly regarding safety, efficacy and cost-effectiveness.

摘要

背景

与其他各大洲类似,欧洲正面临麻醉专业人员短缺的问题,这对受影响国家的国家医疗系统产生了深远影响。

目的

评估麻醉专业人员的现状、组织实践、手术室麻醉医生及其他麻醉服务提供者的职责和规则。

设计

调查。

地点

2022年4月至2023年4月期间,对41个欧洲国家中的39个进行了调查。

参与者

欧洲麻醉与重症监护学会(ESAIC)国家麻醉医生协会委员会(NASC)的代表。

干预措施

由NASC主席挑选的来自法国、德国和意大利的专家小组制定了一份包含16个问题的调查问卷,并发送给所有欧洲国家的NASC代表。

主要观察指标

NASC代表的回复。

结果

欧洲各国麻醉专业人员数量、麻醉团队的组成、角色和职责差异显著。大多数受访者表示存在人员短缺问题,且趋势各异,在某些情况下,新冠疫情后麻醉医生流失加剧了这一问题。各国麻醉医生的薪资存在显著差异。全身麻醉维持、神经阻滞和外周阻滞期间,麻醉医生与患者一对一的比例最为常见;然而,在相当多的情况下,这一比例降至一对二甚至更低。在这种情况下,住院医生或非医生麻醉人员(NPAs)发挥着关键作用,使麻醉医生能够同时监督多名患者。麻醉团队成员的培训差异,以及规范麻醉团队组成及其成员自主权的规则差异也很明显。

结论

该调查提供了欧洲当前麻醉实践的数据。欧洲各国麻醉团队成员的可获得性、组成和组织方式各不相同。该研究突出了手术室组织和麻醉团队组成方面需要进一步关注的领域,特别是在安全性、有效性和成本效益方面。

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