Abstract：
UNASSIGNED: Penile plication is commonly performed for Peyronie\'s disease under general or spinal anesthesia. Conscious sedation (CS) offers decreased anesthetic risks, cost-effectiveness, and the ability to perform the procedure in outpatient settings with shorter wait times. We sought to compare tolerability of penile plication under deep intravenous sedation (DIS) administered by anesthesiologists and nursing-administered CS (NACS).
UNASSIGNED: Tolerability for penile plication was prospectively evaluated, excluding revision surgeries and those with hourglass or hinge deformities. DIS included midazolam and ketamine with infusion of propofol and remifentanil. NACS consisted of midazolam and fentanyl. Baseline characteristics, procedural information, and patient- and surgeon-reported pain assessments were collected. Patients were administered a standardized tolerability questionnaire on follow-up.
UNASSIGNED: Forty patients were enrolled (23 DIS; 17 NACS) with similar baseline characteristics. Median curvature of the DIS cohort was 55° (interquartile range = 43.75-76.25) and 45° (interquartile range = 45-60) in NACS. There was a 100% success rate with no procedure abortion or conversion to general anesthetic. On follow-up, all patients had functional curvature (<20°), and 100% of patients in the DIS and NACS cohorts reported that they would recommend CS to others. Over 93% of patients in both cohorts would choose CS over general anesthetic in the future, with no differences in perioperative and postoperative pain between groups.
UNASSIGNED: Penile plication with CS, whether administered by an anesthesiologist or nursing, is well tolerated with no differences in pain or complications. This indicates that outpatient penile plication with trained nursing staff administering CS can safely reduce costs, risks, and wait times.
UNASSIGNED: Tolerability for penile plication was prospectively evaluated, excluding revision surgeries and those with hourglass or hinge deformities. DIS included midazolam and ketamine with infusion of propofol and remifentanil. NACS consisted of midazolam and fentanyl. Baseline characteristics, procedural information, and patient- and surgeon-reported pain assessments were collected. Patients were administered a standardized tolerability questionnaire on follow-up.
UNASSIGNED: Forty patients were enrolled (23 DIS; 17 NACS) with similar baseline characteristics. Median curvature of the DIS cohort was 55° (interquartile range = 43.75-76.25) and 45° (interquartile range = 45-60) in NACS. There was a 100% success rate with no procedure abortion or conversion to general anesthetic. On follow-up, all patients had functional curvature (<20°), and 100% of patients in the DIS and NACS cohorts reported that they would recommend CS to others. Over 93% of patients in both cohorts would choose CS over general anesthetic in the future, with no differences in perioperative and postoperative pain between groups.
UNASSIGNED: Penile plication with CS, whether administered by an anesthesiologist or nursing, is well tolerated with no differences in pain or complications. This indicates that outpatient penile plication with trained nursing staff administering CS can safely reduce costs, risks, and wait times.
摘要：
■阴茎折叠术通常在全身麻醉或脊髓麻醉下进行。清醒镇静（CS）可降低麻醉风险，成本效益，以及在门诊环境中以更短的等待时间执行该程序的能力。我们试图比较麻醉师和护理CS（NACS）在深静脉镇静（DIS）下阴茎折叠的耐受性。
■对阴茎折叠的耐受性进行了前瞻性评估，不包括翻修手术和沙漏畸形或铰链畸形。DIS包括咪达唑仑和氯胺酮，同时输注异丙酚和瑞芬太尼。NACS由咪达唑仑和芬太尼组成。基线特征，程序信息,收集患者和外科医生报告的疼痛评估.在随访中对患者进行了标准化的耐受性问卷。
■纳入了具有相似基线特征的40例患者（23DIS；17NACS）。在NACS中，DIS队列的中位曲率为55°（四分位距=43.75-76.25）和45°（四分位距=45-60）。没有手术流产或转换为全身麻醉的成功率为100％。关于后续行动，所有患者均有功能弯曲（<20°），DIS和NACS队列中100%的患者报告他们会向其他人推荐CS.两个队列中超过93％的患者将来会选择CS而不是全身麻醉，围手术期和术后疼痛组间无差异。
■阴茎折叠与CS，无论是由麻醉师还是护理人员管理，耐受性良好，疼痛或并发症无差异。这表明，门诊阴茎折叠与训练有素的护理人员管理CS可以安全地降低成本，风险,和等待时间。
■对阴茎折叠的耐受性进行了前瞻性评估，不包括翻修手术和沙漏畸形或铰链畸形。DIS包括咪达唑仑和氯胺酮，同时输注异丙酚和瑞芬太尼。NACS由咪达唑仑和芬太尼组成。基线特征，程序信息,收集患者和外科医生报告的疼痛评估.在随访中对患者进行了标准化的耐受性问卷。
■纳入了具有相似基线特征的40例患者（23DIS；17NACS）。在NACS中，DIS队列的中位曲率为55°（四分位距=43.75-76.25）和45°（四分位距=45-60）。没有手术流产或转换为全身麻醉的成功率为100％。关于后续行动，所有患者均有功能弯曲（<20°），DIS和NACS队列中100%的患者报告他们会向其他人推荐CS.两个队列中超过93％的患者将来会选择CS而不是全身麻醉，围手术期和术后疼痛组间无差异。
■阴茎折叠与CS，无论是由麻醉师还是护理人员管理，耐受性良好，疼痛或并发症无差异。这表明，门诊阴茎折叠与训练有素的护理人员管理CS可以安全地降低成本，风险,和等待时间。
