Mazzei W J
Department of Anesthesiology, University of California, San Diego 92103-8770.
J Clin Anesth. 1994 Sep-Oct;6(5):405-8. doi: 10.1016/s0952-8180(05)80011-x.
To measure the start time for the first case of the day and the turnover times for subsequent cases in the operating rooms (ORs) at an academic hospital.
Prospective study.
ORs at a university medical center.
All patients undergoing an operative procedure that started between 7 A.M. and 5 P.M. weekdays for the period January 1, 1989, through June 30, 1989.
For each patient, the following times were recorded: OR ready, patient enters OR, anesthesia induction complete, surgery start, surgery end, patient leaves OR.
Patients were brought into the OR just before the scheduled start time. Surgical incision was made 21 to 49 minutes after the patient was brought into the OR. Room turnover time (time from patient in to patient out) was almost uniformly 36 minutes. Patient turnover time (time from end of surgery in one patient to end of induction of next patient) was generally 1 hour. Turnover times were shorter for those ORs in which primarily monitored anesthesia care was provided and longer in ORs in which patients routinely required invasive monitoring.
The scheduled start time for the first case of the day was generally the time the patient was brought into the OR. Because of the variable amount of time required for anesthesia induction and surgical preparation and draping, incision occurred 21 to 49 minutes later. The time between cases when no surgery was occurring was significantly longer than room turnover time because of the need to wake up one patient and induce the following patient. Because of a lack of standardized definitions, there is probably a strong perceptual difference among anesthesiologists, OR nurses, and surgeons when viewing start and turnover times. At our own teaching institution, shortening turnover times would increase the amount of elective OR time available, but the impact would not be significant because the number of procedures done per OR each day is low.
测定一所教学医院手术室当日第一例手术的开始时间以及后续手术的周转时间。
前瞻性研究。
大学医学中心的手术室。
1989年1月1日至1989年6月30日工作日上午7点至下午5点期间接受手术的所有患者。
记录每位患者的以下时间：手术室准备好、患者进入手术室、麻醉诱导完成、手术开始、手术结束、患者离开手术室。
患者在预定开始时间前被带入手术室。患者被带入手术室后21至49分钟进行手术切口。房间周转时间（从患者进入到离开的时间）几乎均为36分钟。患者周转时间（从一名患者手术结束到下一名患者诱导开始的时间）通常为1小时。主要提供监护麻醉护理的手术室周转时间较短，而患者常规需要有创监测的手术室周转时间较长。
当日第一例手术的预定开始时间通常是患者被带入手术室的时间。由于麻醉诱导、手术准备和铺巾所需时间不同，手术切口在21至49分钟后进行。由于需要唤醒一名患者并诱导下一名患者，无手术进行时的病例间隔时间明显长于房间周转时间。由于缺乏标准化定义，麻醉医生、手术室护士和外科医生在查看开始时间和周转时间时可能存在很大的认知差异。在我们自己的教学机构，缩短周转时间会增加可用于择期手术的时间，但影响不大，因为每个手术室每天进行的手术数量较少。
