Growth Rates in Pediatric Diagnostic Imaging and Sedation
Growth Rates in Pediatric Diagnostic Imaging and Sedation
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DOI：
10.1213/ane.0b013e3181981f96
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发表时间：
2009-05-01
影响因子：
5.7
通讯作者：
Dow, Angella J.
中科院分区：
文献类型：
--
作者：
Wachtel, Ruth E.;Dexter, Franklin;Dow, Angella J.
背景：在过去的十年中，麻醉提供者使用全身麻醉和/或镇静剂进行儿科诊断成像的工作量大大增加。方法：对一个学术医学中心的数据进行12年的研究。将接受麻醉提供者护理的0-17岁接受磁共振成像(MRI)和/或计算机断层扫描(CT)的儿童数量的增长与儿童进行MRI和CT程序总数的增长进行比较。麻醉提供者包括麻醉师、住院医师、注册护士麻醉师和学生注册护士麻醉师。在研究接近尾声时，医院聘请了一组镇静护士来进行适度镇静。他们为麻醉科的麻醉提供者提供了另一种选择，后者通常会实施全身麻醉。在6个月的时间里，研究了镇静护士和麻醉提供者的使用，以及与扫描持续时间和患者年龄的关系。结果：接受麻醉提供者护理进行MRI和CT扫描的儿童数量随着扫描次数的增加而以每年8%-9%的速度增长。接受麻醉护理的儿童的百分比在12年内没有变化。创建一个提供适度镇静的护士镇静小组并没有改变接受麻醉提供者护理的儿童数量，但确实增加了接受催眠药物治疗的儿童总数。扫描持续时间短于30min时，很少使用麻醉。扫描持续时间的增加与麻醉提供者在按年龄分层后对MRI和CT的使用率增加有关。3-5岁年龄组的麻醉护理率最高。结论：麻醉提供者未来的工作量将取决于进行扫描的总次数的趋势。工作量也可能对增加扫描持续时间或改变3-5岁年龄组患者百分比的因素敏感。它可能还取决于保险公司的报销。(Anesth AnaIg 2009；108：1616-21)
BACKGROUND: Workload has increased greatly over the past decade for anesthesia providers administering general anesthesia and/or sedation for pediatric diagnostic imaging.METHODS: Data from an academic medical center were studied over a 12-yr period. Growth in the number of children 0-17 yr of age undergoing magnetic resonance imaging (MRI) and/or computerized tomography (CT) scans who received care from anesthesia providers was compared with the increase in the total number of MRI and CT procedures performed in children. Anesthesia providers included anesthesiologists, residents, Certified Registered Nurse Anesthetists, and student Certified Registered Nurse Anesthetists. Toward the end of the study, a team of sedation nurses was employed by the hospital to administer moderate sedation. They provided an alternative to anesthesia providers from the anesthesia department, who usually administered general anesthesia. Use of sedation nurses versus anesthesia providers, and the relationship to scan duration and patient age, were studied over a 6-mo period.RESULTS: The number of children receiving care from anesthesia providers for MRI and CT scans grew at the same 8%-9% annual rate as the number of scans performed. The percentage of children receiving anesthesia care did not change over the 12 yr. Creation of a nurse sedation team that provided moderate sedation did not alter the number of children receiving care from anesthesia providers but did increase the total number of children receiving hypnotics. Anesthesia was rarely used for scans shorter than 30 min in duration. Increases in scan duration were associated with increased utilization of anesthesia providers for both MRI and CT after stratifying by age. An age of 3-5 yr was associated with the highest rates of anesthesia care.CONCLUSIONS: Future workload for anesthesia providers administering general anesthesia and/or sedation for pediatric diagnostic imaging will depend on trends in the total number of scans performed. Workload may also be sensitive to factors that increase scan duration or alter the percentage of patients in the 3-5 yr age group. It may additionally depend on reimbursements from insurance companies. (Anesth AnaIg 2009;108:1616-21)