Investigation on development of bronchoscope diagnosis and treatment under general anesthesia in five provinces and cities in China / 中华麻醉学杂志

ABSTRACT

Objective To investigate the development of painless bronchoscope diagnosis and treatment under general anesthesia in five provinces and cities in China.Methods From December 2018 to February 2019,a self-designed electronic questionnaire was sent to related personnels in a department of anesthesiology in hospitals within the range of survey through the WeChat platform.The survey mainly included three aspectsbasic information of hospital,development of bronchoscope diagnosis and treatment under general anesthesia and the specific management plan.Results Questionnaires were sent to 326 hospitals in total,and 261 hospitals responded with a response rate of 80.06％.Among the 261 hospitals involved in the survey,34 hospitals responded that no related diseases were found,and thus the number of valid questionnaires was 227,and the rate of valid questionnaires was 87.0％.Among the 261 hospitals,161 hospitals were tertiary hospitals,and 66 hospitals were secondary hospitals,with a constituent ratio of 70.9％ to 29.1％.The average development rate of painless bronchoscopy was 34.8％,the highest rate was 54.0％ in Beijing,and the lowest rate was 27.5％ in Hebei province.The average development rate of painless bronchoscopy was significantly higher in tertiary hospitals than in secondary hospitals (P＜0.05).The per capita GDP in each region in the past five years was positively correlated with the development of painless bronchoscopic surgery.In hospitals where painless bronchoscope diagnosis and treatment was not performed,the top three reasons for the greatest difficulties in carrying out painless bronchoscopy were insufficient personnel,inadequate technologies and restrictions on hospital management conditions.The number of hospitals using general anesthesia with laryngeal mask ventilation and monitoring anesthesia was larger than that of hospitals using local anesthesia (P＜0.05).In terms of the places where painless bronchoscope diagnosis and treatment was carried out,the number of hospitals selecting the operating room and endoscopic center was larger than that of hospitals choosing intensive care unit or ward,and the number of hospitals selecting the endoscopic center was larger than that of hospitals choosing the operating room (P＜0.05).In terms of anesthesia equipment application for painless bronchoscope diagnosis aud treatment,the number of hospitals applying bispectral index monitoring in operation was significantly less than that of hospitals applying anesthesia machines,micro-pumps and monitors (P＜0.05).In terms of medication for painless bronchoscope diagnosis and treatment,the number of hospitals applying muscle relaxants was significantly smaller and the number of hospitals using inhaled drugs and other types of drugs was less when compared with that of hospitals applying sedatives and analgesics (P＜0.05);for sedatives,the number of hospitals applying propofol was larger than that of hospitals applying other intravenous anesthetic drugs (P＜0.05);for analgesics,there was no significant difference in the number of hospitals applying fentanyl,sufentanil or fentanyl (P＞0.05);the number of hospitals applying sevoflurane was larger as compared with that of hospitals applying desflurane (P＜0.05);in terms of muscle relaxant drug use,there was no significant difference in the number of hospitals applying rocuronium,cisatracurium or vecuronium (P＞0.05).Conclusion At present,the development rate of painless bronchoscopy in China is lower,and the greatest difficulty in further developiment is the shortage of personnel.Bronchoscope diagnosis and treatment under laryngeal mask or under monitoring anesthesia is the most commonly used method in clinic,and general anesthesia under tracheal intubation is more suitable for highly difficult bronchoscope diagnosis and treatment.Opioids combined with propofol is the most commonly used anesthesia method.