无线镇痛泵系统用于骨科术后患者镇痛管理的可行性及有效性研究
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摘要
目的探讨无线镇痛泵系统用于骨科手术患者术后镇痛管理的可行性及有效性。方法将600例骨科术后患者分为两组,使用无线镇痛泵系统镇痛的300例患者为A组,使用传统电子镇痛泵镇痛的300例患者为B组。观察两组患者术后出PACU、术后24 h、48 h、72 h的疼痛强度,按压自控镇痛键的总次数,有效按压次数及镇痛不足次数;记录两组医务人员服务患者的有效处理时间、被叫服务率和主动服务率;测评患者对镇痛治疗的满意度及观察镇痛药物引起的不良反应的发生率。结果两组患者术后各观察时间点的疼痛强度比较,差异无统计学意义(P>0.05);患者按压自控镇痛键的总次数,有效按压次数及镇痛不足次数两组间比较,差异均无统计学意义(P>0.05)。医务人员服务患者的有效处理时间:A组为(10.0±2.33)min,B组为(16.0±3.09)min,差异有统计学意义(P<0.05);B组患者的被叫服务率显著高于A组,而A组患者的主动服务率显著高于B组(P<0.05)。A组患者的镇痛满意度显著高于B组,差异有统计学意义(P<0.05),两组患者关于镇痛药物引起的不良反应发生率无明显差异(P>0.05)。结论无线镇痛泵系统用于骨科手术患者术后镇痛,安全可行,有助于个体化镇痛管理,提高术后疼痛管理质量。
Objective To explore the feasibility and effectiveness of wireless analgesic pump system in postoperative analgesia management in patients receiving orthopedic surgery. Methods A total of 600 patients after orthopedic surgery were divided into two groups. 300 patients who were given analgesia with the use of wireless analgesic pump system were assigned to group A, and 300 patients who were given analgesia with the use of traditional electronic analgesia pump were assigned to group B. The pain intensity upon discharge from PACU, 24 h, 48 h and 72 h after operation, the total number of pressing the self-controlled analgesic button, the number of effective presses and the number of insufficient analgesia were observed in both groups; the effective treatment time, called service rate and active service rate of the two groups of medical staff serving the patients were recorded; the patient's satisfaction with analgesic treatment was measured, and the incidence rate of adverse reactions caused by analgesic drugs was observed. Results There was no statistically significant difference in pain intensity between the two groups at each observation time point after the surgery(P>0.05); there were no statistically significant differences in the total number of pressing the self-controlled analgesic button, the number of effective presses and the number of insufficient analgesia between the two groups(P>0.05). For the effective treatment time of medical staff serving the patients:(10.0±2.33) min in group A, and(16.0±3.09) min in group B. The differences were statistically significant(P<0.05); the called service rate in group B was significantly higher than that in group A, while the active service rate in group A was significantly higher than that in group B. The difference was statistically significant(P<0.05). The satisfaction rate with analgesia in group A was significantly higher than that in group B, and the difference was statistically significant(P<0.05). There was no significant difference in the incidence rate of adverse events caused by analgesic drugs between the two groups(P>0.05). Conclusion The wireless analgesic pump system for postoperative analgesia in patients receiving orthopedic surgery is safe and feasible, which can help individualized analgesic management and improve the quality of postoperative pain management.
Objective To explore the feasibility and effectiveness of wireless analgesic pump system in postoperative analgesia management in patients receiving orthopedic surgery. Methods A total of 600 patients after orthopedic surgery were divided into two groups. 300 patients who were given analgesia with the use of wireless analgesic pump system were assigned to group A, and 300 patients who were given analgesia with the use of traditional electronic analgesia pump were assigned to group B. The pain intensity upon discharge from PACU, 24 h, 48 h and 72 h after operation, the total number of pressing the self-controlled analgesic button, the number of effective presses and the number of insufficient analgesia were observed in both groups; the effective treatment time, called service rate and active service rate of the two groups of medical staff serving the patients were recorded; the patient's satisfaction with analgesic treatment was measured, and the incidence rate of adverse reactions caused by analgesic drugs was observed. Results There was no statistically significant difference in pain intensity between the two groups at each observation time point after the surgery(P>0.05); there were no statistically significant differences in the total number of pressing the self-controlled analgesic button, the number of effective presses and the number of insufficient analgesia between the two groups(P>0.05). For the effective treatment time of medical staff serving the patients:(10.0±2.33) min in group A, and(16.0±3.09) min in group B. The differences were statistically significant(P<0.05); the called service rate in group B was significantly higher than that in group A, while the active service rate in group A was significantly higher than that in group B. The difference was statistically significant(P<0.05). The satisfaction rate with analgesia in group A was significantly higher than that in group B, and the difference was statistically significant(P<0.05). There was no significant difference in the incidence rate of adverse events caused by analgesic drugs between the two groups(P>0.05). Conclusion The wireless analgesic pump system for postoperative analgesia in patients receiving orthopedic surgery is safe and feasible, which can help individualized analgesic management and improve the quality of postoperative pain management.
引文
[1]Luna I,Kehlet H,Petersen M,et al.Clinical,nociceptive and psychological profiling to predict acute pain after total knee arthroplasty[J].Acta Anaesthesiol Scand,2017,61(6):676-687.
[2]Stacey B,Rudy T,Nellhaus D.Management of patientcontrolled analgesia:A comparison of primary surgeons and a dedicated pain service[J].Anesthesia&Analgesia,1997,85(1):130-134.
[3]Darin J,Kamen V,lgor K.No evidence of real progress intreatment of acute pain,1993-2012:Scientometric analysis[J].Journal of Pain Research,2014,7:199-210.
[4]Karanikolas M,Aretha D,Monantera G,et al.Intravenous fentanyl patient-controlled analgesia for perioperative treatment of neuropathic/ischaemic pain in haemodialysis patients:A case series[J].Journal of Clinical Pharmacy and Therapeutics,2010,35(5):603-608.
[5]Grass J.Patient-controlled analgesia[J].Anesthesia&Analgesia,2005,101(5S):S44-S61.
[6]Doyle D,Vicente K.Electrical short circuit as a possible cause of death inpatients on PCA machines:Report on an opiate overdose and a possible preventiveremedy[J].The Journal of the American Society of Anesthesiologists,2001,94(5):940-940.
[7]Hutchison R.Challenges in acute post-operative pain management[J].American Journal of Health-System Pharmacy,2007,64(6 Supplement 4):S2-S5.
[8]Zenilman ME.More powerful than the American Society of Anesthesiology score[J].JAMA Surg,2014,149(7):640-641.
[9]Choi YM,Byeon GJ,Park SJ,et al.Postoperative analgesic efficacy of single-shot and continuous transversus abdominis plane block after laparoscopic cholecystectomy:A randomized controlled clinical trial[J].J Clin Anesth,2017,39:146-151.
[10]Harikesavan K,Chakravarty RD,Maiya AG,et al.Hip abductor strengthening improves physical function following total knee replacement:One-year follow-up of a randomized pilot study[J].Open Rheumatol J,2017,31(11):30-42.
[11]Graves SE,Steiger R,Davidson D,et al.The use of femoral stems with exchangeable necks in primary total hip arthroplasty increases the rate of revision[J].Bone Joint J,2017,99-B(6):766-773.
[12]Lindley E,Milligan K,Farmer R,et a1.Patient—Controlled transdermal fentanyl versus intravenous morphine pump after spine surgery[J].Orthopedics,2015,38(9):e819-e824.
[13]Koh JC,Song Y,Kim SY,et a1.Postoperative pain and patient-controlled epidural analgesia-related adverse effects in young and elderly patients:A retrospective analysis of 2,435 patients[J].J Pain Res,2017,12(10):897-904.
[14]Bell L,Duffy A.Pain assessment and management in surgical nursing:A literature review[J].Br J Nurs,2009,18(3):153-156.
[15]朱滨.基于Wi-Fi无线技术的智能镇痛泵系统设计[J].临床医学工程,2012,19(8):1243-1244.
[16]严峰,李军,王浩杰,等.无线数字信息化技术用于术后患者镇痛管理的研究和分析[J].中国医师杂志,2016,18(1):88-91.
[17]唐碧云,张丽芳,朱勇满,等.急性疼痛服务团队早期干预对患者术后自控镇痛效果的影响[J].中华麻醉学杂志,2012,32(6):792-793.
[18]付霜,曲丕盛,袁晓红,等.应用无线镇痛系统治疗难治性癌痛的临床观察[J].中国现代医生,2015,53(2):104-106.
[19]徐建国,吴新民,罗爱伦,等.成人术后疼痛处理专家共识[J].临床麻醉学杂志,2010,26(3):1190-1196.
[20]王浩然,曹汉忠.无线镇痛泵系统的应用效果探讨[J].中外医疗,2015,(3):52-54.
[2]Stacey B,Rudy T,Nellhaus D.Management of patientcontrolled analgesia:A comparison of primary surgeons and a dedicated pain service[J].Anesthesia&Analgesia,1997,85(1):130-134.
[3]Darin J,Kamen V,lgor K.No evidence of real progress intreatment of acute pain,1993-2012:Scientometric analysis[J].Journal of Pain Research,2014,7:199-210.
[4]Karanikolas M,Aretha D,Monantera G,et al.Intravenous fentanyl patient-controlled analgesia for perioperative treatment of neuropathic/ischaemic pain in haemodialysis patients:A case series[J].Journal of Clinical Pharmacy and Therapeutics,2010,35(5):603-608.
[5]Grass J.Patient-controlled analgesia[J].Anesthesia&Analgesia,2005,101(5S):S44-S61.
[6]Doyle D,Vicente K.Electrical short circuit as a possible cause of death inpatients on PCA machines:Report on an opiate overdose and a possible preventiveremedy[J].The Journal of the American Society of Anesthesiologists,2001,94(5):940-940.
[7]Hutchison R.Challenges in acute post-operative pain management[J].American Journal of Health-System Pharmacy,2007,64(6 Supplement 4):S2-S5.
[8]Zenilman ME.More powerful than the American Society of Anesthesiology score[J].JAMA Surg,2014,149(7):640-641.
[9]Choi YM,Byeon GJ,Park SJ,et al.Postoperative analgesic efficacy of single-shot and continuous transversus abdominis plane block after laparoscopic cholecystectomy:A randomized controlled clinical trial[J].J Clin Anesth,2017,39:146-151.
[10]Harikesavan K,Chakravarty RD,Maiya AG,et al.Hip abductor strengthening improves physical function following total knee replacement:One-year follow-up of a randomized pilot study[J].Open Rheumatol J,2017,31(11):30-42.
[11]Graves SE,Steiger R,Davidson D,et al.The use of femoral stems with exchangeable necks in primary total hip arthroplasty increases the rate of revision[J].Bone Joint J,2017,99-B(6):766-773.
[12]Lindley E,Milligan K,Farmer R,et a1.Patient—Controlled transdermal fentanyl versus intravenous morphine pump after spine surgery[J].Orthopedics,2015,38(9):e819-e824.
[13]Koh JC,Song Y,Kim SY,et a1.Postoperative pain and patient-controlled epidural analgesia-related adverse effects in young and elderly patients:A retrospective analysis of 2,435 patients[J].J Pain Res,2017,12(10):897-904.
[14]Bell L,Duffy A.Pain assessment and management in surgical nursing:A literature review[J].Br J Nurs,2009,18(3):153-156.
[15]朱滨.基于Wi-Fi无线技术的智能镇痛泵系统设计[J].临床医学工程,2012,19(8):1243-1244.
[16]严峰,李军,王浩杰,等.无线数字信息化技术用于术后患者镇痛管理的研究和分析[J].中国医师杂志,2016,18(1):88-91.
[17]唐碧云,张丽芳,朱勇满,等.急性疼痛服务团队早期干预对患者术后自控镇痛效果的影响[J].中华麻醉学杂志,2012,32(6):792-793.
[18]付霜,曲丕盛,袁晓红,等.应用无线镇痛系统治疗难治性癌痛的临床观察[J].中国现代医生,2015,53(2):104-106.
[19]徐建国,吴新民,罗爱伦,等.成人术后疼痛处理专家共识[J].临床麻醉学杂志,2010,26(3):1190-1196.
[20]王浩然,曹汉忠.无线镇痛泵系统的应用效果探讨[J].中外医疗,2015,(3):52-54.