脑功能状态仪疼痛指数在患者术后疼痛评估中的应用
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摘要
目的研究脑功能状态仪疼痛指数(PI)在术后患者疼痛评估价值和应用。方法选择2016年5月至2018年9月本院骨科四肢创伤患者200例,男114例,女86例,年龄23～63岁,BMI 20～25 kg/m~2,ASAⅠ或Ⅱ级。分别采用脑功能状态仪疼痛指数(PI)和视觉模拟评分法(VAS评分)对患者术后2、6、24和48 h疼痛进行评分,并记录不同疼痛程度患者的例数。比较两种方法的评分时间、分析两者评价的一致性。结果脑功能状态仪PI评估患者疼痛所需的评分时间为(2.36±0.67)min,VAS评分评估患者疼痛所需的评分时间(2.24±0.59)min,差异无统计学意义,但PI可以连续评估患者的疼痛,评估不可主观交流的患者疼痛。PI与VAS评分在术后2、6、24和48 h疼痛评分加权Kappa分析显示具有一致性,其中术后2 h两者的一致性Kappa值最高。结论脑功能状态仪PI与VAS评分对患者术后疼痛的评分具有较高的一致性。PI可以有效评估患者在各种状态下的疼痛程度,有利于临床镇痛工作的开展。
Objective To investigate the value and application of pain index(PI) using cerebral state monitor for the assessment of postoperative pain. Methods A total of 200 patients with limb trauma, from May 2016 to September 2018, including 114 males and 86 females, aged 23-63 years, with BMI 20-25 kg/m~2 and ASA physical status Ⅰ or Ⅱ. PI and visual analogue scale(VAS) were used to respectively grade the postoperative pain at 2, 6, 24 and 48 h, and the number of patients with different degrees of pain was recorded. We compared the evaluation time and analyzed the consistency between the two methods. Results The pain assessment with PI took(2.36 ± 0.67) min. As for VAS, the evaluation time was(2.24 ± 0.59) min. There was no significant difference in evaluation time between the two methods. But PI is available for continuous pain assessment and patients who can't subjectively describe their pain. Weighted Kappa analysis of PI and VAS at 2, 6, 24 and 48 h after operation showed good consistency, and the highest Kappa values were found at 2 h after operation. Conclusion PI and VAS have high consistency in the evaluation of postoperative pain. PI can effectively evaluate the pain degree of patients in various states, which is conducive to the development of clinical analgesia work.
Objective To investigate the value and application of pain index(PI) using cerebral state monitor for the assessment of postoperative pain. Methods A total of 200 patients with limb trauma, from May 2016 to September 2018, including 114 males and 86 females, aged 23-63 years, with BMI 20-25 kg/m~2 and ASA physical status Ⅰ or Ⅱ. PI and visual analogue scale(VAS) were used to respectively grade the postoperative pain at 2, 6, 24 and 48 h, and the number of patients with different degrees of pain was recorded. We compared the evaluation time and analyzed the consistency between the two methods. Results The pain assessment with PI took(2.36 ± 0.67) min. As for VAS, the evaluation time was(2.24 ± 0.59) min. There was no significant difference in evaluation time between the two methods. But PI is available for continuous pain assessment and patients who can't subjectively describe their pain. Weighted Kappa analysis of PI and VAS at 2, 6, 24 and 48 h after operation showed good consistency, and the highest Kappa values were found at 2 h after operation. Conclusion PI and VAS have high consistency in the evaluation of postoperative pain. PI can effectively evaluate the pain degree of patients in various states, which is conducive to the development of clinical analgesia work.
引文
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[8] 昝望,潘鑫,熊苗苗,等.术前高度焦虑相关致痛因子的变化及其对术后疼痛的影响.临床麻醉学杂志,2018,34(8):768-772.
[9] 康娜,吴安石.脑电疼痛指数评估分娩镇痛产妇疼痛程度的有效性.临床麻醉学杂志,2018,34(4):391-393.
[2] Tapar H,Suren M,Karaman S,et al.Alt?parmak F.Evaluation of the perfusion index according to the visual analog scale in postoperative patients.Saudi Med J,2018,39(10):1006-1010.
[3] Klein C,Caumo W,Gélinas C,et al.Validation of two pain assessment tools using a standardized nociceptive stimulation in critically Ill adults.J Pain Symptom Manage,2018,56(4):594-601.
[4] 吴一兵.脑电波中脑功能状态认知指数在不同特征人群中的分布特点研究.实用心脑肺血管病杂志,2018,(6):53-57.
[5] Hao S,Tian B,Wang L,et al.A primary evaluation of VAS for use in clinical experimental pain assessment.Zhongguo Yi Xue Ke Xue Yuan Xue Bao,1994,16(5):397-399.
[6] Riganello F,Chatelle C,Schnakers C,et al.Heart rate variability as an indicator of nociceptive pain in disorders of consciousness.J Pain Symptom Manage,2019,57(1):47-56.
[7] 谢海,李艳,吴多志,等.瞳孔直径变化对术后疼痛评估的价值.临床麻醉学杂志,2016,32(2):134-138.
[8] 昝望,潘鑫,熊苗苗,等.术前高度焦虑相关致痛因子的变化及其对术后疼痛的影响.临床麻醉学杂志,2018,34(8):768-772.
[9] 康娜,吴安石.脑电疼痛指数评估分娩镇痛产妇疼痛程度的有效性.临床麻醉学杂志,2018,34(4):391-393.