PDF(Pubmed)
Abstract：
UNASSIGNED: The use of local anaesthetics (LAs) is usually associated with few adverse effects, but local anaesthetic systemic toxicity (LAST) can result in serious harm and even death. However, practitioner awareness regarding this risk has been little studied.
UNASSIGNED: This was a closed, web-based study carried out at two Swiss university hospitals using a fully automated questionnaire. The main objective was to evaluate LAST awareness and LA use among various medical practitioners. The secondary objective was to determine whether these physicians felt that a tool designed to compute maximum safe LA doses should be developed.
UNASSIGNED: The overall participation rate was 40.2 % and was higher among anaesthesiologists (154/249, 61.8 % vs 159/530, 30.0 %; P < .001). Anaesthesiologists identified the risk of LAST and the systems involved more frequently than non-anaesthesiologists (85.1 % vs 43.4 %, P < .001). After adjusting for years of clinical experience, age, country of diploma, frequency of LA use, clinical position and being an anaesthesiologist, the only significant associations were this latter factor (P < .001) and clinical position (P = .016 for fellows and P = .046 for consultants, respectively). Most respondents supported the development of a tool designed to compute maximum safe LA doses (251/313, 80.2 %) and particularly of a mobile app (190/251, 75.7 %).
UNASSIGNED: LAST awareness is limited among practitioners who use LAs on a regular basis. Educational interventions should be created, and tools designed to help calculate maximum safe LA doses developed. The actual frequency of unsafe LA doses administration would also deserve further study.
UNASSIGNED: This was a closed, web-based study carried out at two Swiss university hospitals using a fully automated questionnaire. The main objective was to evaluate LAST awareness and LA use among various medical practitioners. The secondary objective was to determine whether these physicians felt that a tool designed to compute maximum safe LA doses should be developed.
UNASSIGNED: The overall participation rate was 40.2 % and was higher among anaesthesiologists (154/249, 61.8 % vs 159/530, 30.0 %; P < .001). Anaesthesiologists identified the risk of LAST and the systems involved more frequently than non-anaesthesiologists (85.1 % vs 43.4 %, P < .001). After adjusting for years of clinical experience, age, country of diploma, frequency of LA use, clinical position and being an anaesthesiologist, the only significant associations were this latter factor (P < .001) and clinical position (P = .016 for fellows and P = .046 for consultants, respectively). Most respondents supported the development of a tool designed to compute maximum safe LA doses (251/313, 80.2 %) and particularly of a mobile app (190/251, 75.7 %).
UNASSIGNED: LAST awareness is limited among practitioners who use LAs on a regular basis. Educational interventions should be created, and tools designed to help calculate maximum safe LA doses developed. The actual frequency of unsafe LA doses administration would also deserve further study.
摘要：
■使用局部麻醉药（LA）通常与很少的不良反应有关，但局部麻醉系统毒性（LAST）可导致严重伤害甚至死亡。然而,从业人员对这种风险的认识很少研究。
■这是一个封闭的，在瑞士的两家大学医院进行的基于网络的研究使用全自动问卷。主要目的是评估各种医生的LAST意识和LA使用情况。次要目标是确定这些医生是否认为应该开发一种旨在计算最大安全LA剂量的工具。
■总体参与率为40.2%，麻醉医师的参与率更高（154/249，61.8%vs159/530，30.0%；P<.001）。麻醉师发现LAST的风险，与非麻醉师相比，系统涉及的风险更高（85.1％vs43.4％，P<.001)。经过多年的临床经验调整后，年龄,国家的文凭，洛杉矶使用的频率，临床位置和麻醉师，唯一显著的关联是后一个因素(P<.001)和临床职位(研究员P=.016，顾问P=.046，分别)。大多数受访者支持开发用于计算最大安全LA剂量的工具（251/313，80.2％），尤其是移动应用程序（190/251，75.7％）。
■在定期使用LAs的从业者中，最后的意识是有限的。应该建立教育干预措施，以及旨在帮助计算最大安全LA剂量的工具。不安全LA剂量给药的实际频率也值得进一步研究。
■这是一个封闭的，在瑞士的两家大学医院进行的基于网络的研究使用全自动问卷。主要目的是评估各种医生的LAST意识和LA使用情况。次要目标是确定这些医生是否认为应该开发一种旨在计算最大安全LA剂量的工具。
■总体参与率为40.2%，麻醉医师的参与率更高（154/249，61.8%vs159/530，30.0%；P<.001）。麻醉师发现LAST的风险，与非麻醉师相比，系统涉及的风险更高（85.1％vs43.4％，P<.001)。经过多年的临床经验调整后，年龄,国家的文凭，洛杉矶使用的频率，临床位置和麻醉师，唯一显著的关联是后一个因素(P<.001)和临床职位(研究员P=.016，顾问P=.046，分别)。大多数受访者支持开发用于计算最大安全LA剂量的工具（251/313，80.2％），尤其是移动应用程序（190/251，75.7％）。
■在定期使用LAs的从业者中，最后的意识是有限的。应该建立教育干预措施，以及旨在帮助计算最大安全LA剂量的工具。不安全LA剂量给药的实际频率也值得进一步研究。
