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遵守肥胖治疗中心减重手术的加速康复外科(ERAS)协议建议。

Compliance with Enhanced Recovery After Surgery (ERAS) protocol recommendations for bariatric surgery in an obesity treatment center.

机构信息

Universidade do Sul de Santa Catarina, Tubarão, SC, Brasil.

Universidade do Sul de Santa Catarina, Tubarão, SC, Brasil.

出版信息

Braz J Anesthesiol. 2023 Jan-Feb;73(1):36-41. doi: 10.1016/j.bjane.2021.10.018. Epub 2021 Dec 25.

Abstract

INTRODUCTION

The higher risk of perioperative complications associated with obesity has made anesthesiologists increasingly concerned with the management of obese patients. Measures that improve bariatric surgery patient safety have become essential. The implementation of ERAS protocols in several surgical specialties has made it possible to achieve appropriate outcomes as to surgery safety. The aim of this study was to evaluate patient compliance with the recommendations of an ERAS protocol for Bariatric Surgery (ERABS) at a hospital specialized in obesity treatment.

METHODS

Cross-sectional study, using a medical record database, in a hospital certified as an International Center of Excellence in Bariatric and Metabolic Surgery. The definition of the variables to be assessed was based on the most recent ERABS proposed by Thorell et al. Results were analyzed using descriptive epidemiology.

RESULTS

The study evaluated all patients undergoing bariatric surgery in 2019. Mean compliance with the recommendations per participant was 42.8%, with a maximum of 55.5%, and was distributed as follows: 22.6% of compliance with preoperative recommendations, 60% to intraoperative recommendations, and 58.1% to postoperative recommendations. The anesthesiologist is the professional who provides most measures for the perioperative optimization of bariatric surgery patients. In our study we found that anesthesiologists complied with only 39.5% of ERABS recommendations.

CONCLUSIONS

Mean compliance with ERABS recommendations per participant was 42.8%. Considering that the study was carried out at a hospital certified as an international center of excellence, the need for introducing improvements in the care of patients to be submitted to bariatric surgery is evident.

摘要

引言

肥胖相关围手术期并发症风险较高,这使得麻醉师越来越关注肥胖患者的管理。提高减重手术患者安全性的措施已变得至关重要。在多个外科专业中实施 ERAS 方案已经使得实现适当的手术安全性结果成为可能。本研究旨在评估一家专门治疗肥胖症的医院中肥胖患者对减重手术加速康复外科(ERABS)方案建议的患者依从性。

方法

这是一项在一家被认证为肥胖和代谢外科国际卓越中心的医院中使用病历数据库进行的横断面研究。评估变量的定义基于 Thorell 等人提出的最新 ERABS。使用描述性流行病学方法分析结果。

结果

本研究评估了 2019 年接受减重手术的所有患者。每位参与者建议的平均依从率为 42.8%,最高可达 55.5%,分布如下:术前建议的依从率为 22.6%,术中建议的依从率为 60%,术后建议的依从率为 58.1%。麻醉师是为肥胖患者围手术期优化提供最多措施的专业人员。在我们的研究中,我们发现麻醉师仅遵守了 39.5%的 ERABS 建议。

结论

每位参与者对 ERABS 建议的平均依从率为 42.8%。考虑到该研究是在一家被认证为国际卓越中心的医院进行的,显然需要引入改进措施来照顾将要接受减重手术的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4771/9801194/92a560346540/gr1.jpg

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