我国麻醉医师对麻醉深度监测仪使用现状及态度的调查

Current application status and attitude of depth of anesthesia monitoring devices in Chinese anesthesiologists

目的 对我国麻醉医师进行问卷调查,分析麻醉医师对麻醉深度(depth of anesthesia, DoA)监测仪的使用现状及其对DoA监测仪有效性的评价。方法 选择已获得执业医师资格证的中国麻醉医师为调研对象。2020年7-9月在全国范围内通过发送微信调研表对12 750名麻醉医师进行调研,完成被调研者对DoA监测仪使用情况及有效性等数据的收集,最终获得有效问卷4 037份。采用SPSS 26.0软件,数据以百分比和95%置信区间(CI)的形式表示,进行卡方检验对获得的调研数据进行统计分析。结果 (1)在临床麻醉中常规使用DoA监测仪者仅占9.1%。教学医院[非常熟悉的比例30.3%(28.3%~32.3%)]和三甲医院[非常熟悉的比例28.8%(27.1%~30.6%)]的麻醉医师对DoA监测仪的熟悉程度分别高于非教学医院[非常熟悉的比例14.8%(13.2%~16.4%)]和非三甲医院[非常熟悉的比例11.8%(10.1%~13.5%)]。65.4%的麻醉医师认为DoA监测仪的3个脑电参数同等重要,其中教学医院医师比例[66.7%(64.7%~68.7%)]高于非教学医院[64.1%(62.0%~66.2%)],但95%CI有重叠,差异无统计学意义。(2)96.5%的麻醉医师认为DoA监测仪能有效监测麻醉深度。而麻醉医师对不同类型DoA监测仪的有效性评价无明显差异。(3)不同职称的麻醉医师认为不同的全身麻醉方法均需使用DoA监测仪,仅对保留自主呼吸的麻醉方式是否需要DoA监测仪的看法有统计学差异(P<0.05)。结论 我国DoA监测仪使用率较低,不同类型DoA监测仪均能有效监测DoA并适用于不同的全身麻醉方法,值得临床推广使用。

Objective To understand the current status of application of depth of anesthesia(DoA) monitors used by anesthesiologists in China and evaluated its validity. Methods Chinese anesthesiologists who have been licensed as medical practitioners were selected as the research objects. A nationwide online survey was carried out by sending a WeChat survey form to 12 750 anesthesiologists during July and September 2020, and the data of DoA monitor usage and effectiveness were collected. Finally, 4 037 valid questionnaires were obtained. The survey data were analyzed using SPSS 26.0 software. The data were expressed as proportions with 95% confidence interval(CI), and Chi-square test was conducted for statistical analysis. Results(1) Only 9.1% of anesthesiologists routinely used DoA monitors in clinical anesthesia. Anesthesiologists in teaching hospitals [proportion of very familiar: 30.3%(28.3%~32.3%)] and grade-A tertiary hospitals [proportion of very familiar: 28.8%(27.1%~30.6%)] were more familiar with DoA monitors than those in non-teaching hospitals [proportion of very familiar: 14.8%(13.2%~16.4%)] and non-grade-A tertiary hospitals [proportion of very familiar: 11.8%(10.1%~13.5%)], respectively. Among the participants, 65.4% of them considered that the 3 electroencephalogram parameters of DoA monitors were equally important, with the proportion of anesthesiologists in teaching hospitals [66.7%(64.7%~68.7%)] higher than that in non-teaching hospitals [64.1%(62.0%~66.2%)], though no statistical difference due to 95%CI overlapping.(2) 96.5% of anesthesiologists believed that the DoA monitors could effectively monitor DoA. However, there was no significant difference in anesthesiologists’ evaluation of the effectiveness of different DoA monitors.(3) Anesthesiologists with different titles believed that DoA monitors were indispensable for different general anesthesia methods, but statistical difference was seen in whether DoA monitors were required for general anesthesia preserving spontaneous respiration(P<0.05). Conclusion The usage of DoA monitors in China is quite low. Different types of DoA monitors are effective for DoA monitoring and suitable for different general anesthesia methods, which are worthy of clinical application.