罂粟摘要 气管插管期间使用防护套可降低职业焦虑：一项随机对照试验
贵州医科大学 麻醉与心脏电生理课题组
翻译：张中伟 编辑：马艳燕 审校：曹莹
在新型冠状病毒2019（COVID-19）流行期间，气管插管时高风险的交叉感染已经引起麻醉医生过度的职业焦虑。目前，在临床实践中还没有有效缓解焦虑的方法。我们发现，装备更完善的防护设备可在气管插管期间降低麻醉医生的焦虑程度。
在这项研究中，纳入了60名在手术室接受气管插管和拔管的患者，以1:1的比例随机分为两组，一组麻醉医生使用防护套（防护套组），另一组麻醉医生不使用防护套（对照组）。采用视觉模拟评分（VAS）评估麻醉医生在插管期间的焦虑水平。记录患者在防护套上留下呼吸液滴的情况，以及麻醉医生对患者口腔异味的不适、劳累程度、满意度、腰部不适和肩部不适的情况。评估并记录患者的焦虑程度、压抑感、低氧血症的发生及术后并发症发生情况。
与对照组相比，防护套组的麻醉医生在插管和拔管过程中的焦虑评分较低，满意度较高（P<0.05）。在防护套内侧可观察到呼吸液滴，而在防护套外侧未观察到呼吸液滴（P<0.001）。在防护套组中，麻醉医生感知患者口腔异味的发生率显著降低（P=0.02），防护套组中没有患者出现低氧血症或气管插管相关并发症。
使用防护装置进行气管插管可能会避免患者向麻醉医生传播液滴，同时也会减少麻醉医生在手术室环境中的焦虑程度。
原始文献来源：Chaojin Chen, Ning Shen, Liubing Chen, et al. Application of a protective sleeve is associated with decreased occupational anxiety during endotracheal intubation: a randomized controlled trial.[J]. BMC Anesthesiol(2021)21:251 :1.
英文原文
Application of a protective sleeve
is associated with decreased occupational
anxiety during endotracheal intubation:
a randomized controlled trial
Abstract
Background: The high risk of cross-infection during tracheal intubation has caused excessive occupational anxiety for anaesthesiologists amid the novel coronavirus disease 2019 (COVID-19) pandemic. Currently, there is no effective way to attenuate their anxiety in clinical practice. We found that anaesthesiologist with better protective equipment might experience decreased levels of anxiety during intubation.
Method:In this study, 60 patients who underwent intubation and extubation in the operating room were enrolled, and then randomized 1:1 to either wear protective sleeves (protective sleeve group) or not (control group). Visual
analogue scale (VAS) was used to measure the anxiety level of anaesthesiologists during intubation. The respiratory droplets of patients on the sleeve, and the anaesthesiologists’ perception including the patient’s oral malodour, exertion, satisfaction degree, waist discomfort and shoulder discomfort were recorded. The patients’ anxiety, oppressed feelings and hypoxia and postoperative complications were all measured and recorded.
Results:Compared with the control group, the anaesthesiologists in protective sleeve group achieved lower anxiety scores and better satisfaction degrees during the process of intubation and extubation (all P < 0.05). Respiratory droplets were observed only on the inner side, but not the external side, of the protective sleeves (P < 0.001). The incidence of the anaesthesiologists’ perception of patients’ oral malodour was significantly lower in the protective sleeve group (P = 0.02) and no patients developed hypoxemia or intubation-related complications in the protective sleeve group.
Conclusion:Using protective devices for intubation might eliminate droplet transmission from patients to anaesthesiologists, while also decreasing their anxiety in a controlled operating room environment.
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