Anesthetic and Perioperative Risk Assessment Before Programmed Surgery: Anesthetic Teleconsultation Versus Face-to-face Anesthesia Consultation.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 172
- 试验地点
- 2
- 主要终点
- Elevated American Society of Anesthesiologists (ASA) score in each group
研究概览
简要总结
The anesthesia safety decree made it compulsory in 1994 to carry out a pre-anesthesia consultation before any operative or interventional act. With the inclusion of telemedicine in the Public Health Code then the publication of Addendum 6 in 2018 and finally the derogatory decree in March 2020, it is possible to perform and bill for pre-anesthesia consultation via telemedicine.
The consultation is always followed by a pre-anesthetic visit upon admission of the patient the day before or the day of the operation to verify the information recorded during the consultation and the patient's state of health. This identifies elements omitted during the pre-anesthesia consultation (face-to-face or remotely) and reduces the risks of potential postponement.
The study investigators hypothesize that there would be no difference in the quality of the information given, the collection of medical, paramedical and medication elements and the evaluation of the operative risk in anesthesia consultation via teleconsultation versus face-to-face. The critical points are the medication reconciliation of the patient's treatments, the overall assessment of the operative risk and anticipated difficulty of access to the airways (mouth opening: ≥ or <35 mmm).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The patient must have given their free and informed consent and signed the consent form
- •The patient must be a member or beneficiary of a health insurance plan
- •Patient with scheduled surgical intervention (outpatient or hospitalization) at the Nîmes University Hospital requiring a preoperative anesthesia consultation.
- •Patient with computer equipment at home allowing the use of the Téléo software (computer equipment with web cam, audio and microphone or smartphone).
排除标准
- •The subject is participating in a category 1 interventional study, or is in a period of exclusion determined by a previous study
- •The subject refuses to sign the consent
- •It is impossible to give the subject informed information
- •The patient is under safeguard of justice or state guardianship
- •Patient who has already had an anesthesia consultation for surgery within the previous 6 months.
- •Emergency or radiology and / or interventional surgery (eg. gastroscopy, biopsy under scanner, etc.).
结局指标
主要结局
Elevated American Society of Anesthesiologists (ASA) score in each group
时间窗: pre-anesthetic visit = 9 days to 3 months+7 days after inclusion
Yes/no for if score=3-4
Difficulty in accessing airways each group
时间窗: pre-anesthetic visit = 9 days to 3 months+7 days after inclusion
Yes/no for mouth opening ≥35 mm
Medication conciliation performed during the anesthesia consultation each group
时间窗: anesthesia consultation = 1 week to 3 months after inclusion
Yes/no: adaptations of selected therapies: anticoagulants, anti-aggregants, anti-hypertension, antidiabetics
Difference between groups in composite score of above outcomes (elevated ASA score, difficulty accessing airways and medication conciliation)
时间窗: anesthesia consultation = 1 week to 3 months after inclusion
Difference in number of yes/no answers at anesthesia consultation compared to pre- anesthetic visit
次要结局
- Ecological impact of the consultation in each group(pre-anesthetic visit = 9 days to 3 months+7 days after inclusion)
- Economic impact of the consultation in each group(pre-anesthetic visit = 9 days to 3 months+7 days after inclusion)
- Rate of presence of the usual treatment prescription(During the anesthesia consultation = 1 week to 3 months after inclusion)
- Rate of presence of the completed health questionnaire(During the anesthesia consultation = 1 week to 3 months after inclusion)
- Reason for cancellation of surgery(Day 2 after pre-anesthetic visit)
- Number of canceled surgeries in each group(Day 2 after pre-anesthetic visit)
- Number of delayed surgeries in each group(Day 2 after pre-anesthetic visit)
- Reason for delayed surgery(Day 2 after pre-anesthetic visit)
- Complication rate in perioperative and immediate postoperative period(2 days post-operatively)
- Global patient satisfaction(pre-anesthetic visit = 9 days to 3 months+7 days after inclusion)
- Rate of anesthesia consultation rescheduling in each group(2 days after pre-anesthetic visit)
- Reason for rescheduling(2 days after pre-anesthetic visit)
- Satisfaction on the delivery of the information(pre-anesthetic visit = 9 days to 3 months+7 days after inclusion)
- Rate of presence of specialist consultation reports less than 1 year old(During the anesthesia consultation = 1 week to 3 months after inclusion)