无线远程监控镇痛泵与普通镇痛泵系统临床应用效果比较
|
摘要
目的比较无线远程监控镇痛泵系统和普通电子镇痛泵系统在腹腔镜下肠癌根治术后的镇痛效果。方法选取择期行腹腔镜下肠癌根治术并术后需要行静脉自控镇痛(PCIA)治疗的患者120例,按随机数字表法分为无线镇痛组(W组)和普通镇痛组(P组),每组60例。两组分别在手术结束拔除气管插管后接镇痛泵,应用视觉模拟评分法(VAS)分别记录患者术后2、6、12、24、48h的疼痛评分,术后3d内患者的舒适状况评分,记录每日镇痛药物的用量,镇痛不足的补救次数及麻醉医生接到镇痛不足信息后到达病房进行有效处理疼痛的时间,患者自控镇痛按压的总次数及有效次数,记录镇痛相关并发症,患者及医务人员的满意度等情况。结果静息状态下,术后6h VAS评分W组低于P组(P<0.05);活动状态下,术后2h及6h VAS评分W组低于P组(P<0.05)。患者3d内记录的舒适状况评分W组高于P组(P<0.05)。患者在镇痛期间,第一个24h镇痛药物的使用量W组高于P组(P<0.05)。两组的疼痛处理时间W组低于P组(P<0.01)。患者按压自控镇痛键的总次数W组低于P组(P<0.05)。患者及医护人员对PCIA治疗后的总体满意度W组均高于P组(P<0.05)。结论与传统镇痛泵比较,无线远程监控镇痛泵系统在腹腔镜下肠癌根治术后的应用能更加有效管理患者的疼痛,加速患者的早期康复,增加患者术后的舒适度及满意度。
Objective To compare the analgesic effect of the wireless remote patient-controlled intravenous analgesia(PICA) monitoring system with conventional analgesia pump system for colorectal cancer patients after laparoscopic radical resection.Methods One hundred and twenty patients,who received laparoscopic surgery for colorectal and needed PCIA after the operation,were randomly assigned to two groups:the wireless monitoring group(group W,n=60) and the conventional PCIA group(group P,n=60).The use of analgesia pumps started after tracheal extubation;pain rating VAS was scored at 2,6,12,24,48 h after PCIA started and the comfort status score after PCIA was assessed for 3 d.The daily dose of analgesics,the times of additional analgesia demanded,the times of pain management by medical staff,the total number and effective number of the PCIA pressing,the analgesia related complications,the satisfaction of patients and medical staff were documented in two groups.Results Compared with group P,the pain rating VAS was lower in group Wat 6 h in resting state(P<0.05),and at 2 h,6 h in active state(P<0.05);the comfort status score for 3 d of PCIA was higher in group W(P<0.05).Analgesic dosage of group Wwas higher than that of group P in the first 24 h(P<0.05).The pain management time by medical staff in group Wwas significantly shorter than that in the group P(P<0.01).The total pressing number of PCIA in group Wwas less than that in group P(P<0.05).After 48 h of PCIA treatment,satisfaction of patients and medical staff were higher in group W(P<0.05).Conclusion Compared with the conventional analgesia pump,the wireless remote patient-controlled intravenous analgesia monitoring system can more effectively control the pain,accelerate the early recovery,increase the comfort status and satisfaction of colorectal cancer patients after laparoscopic radical resection.
Objective To compare the analgesic effect of the wireless remote patient-controlled intravenous analgesia(PICA) monitoring system with conventional analgesia pump system for colorectal cancer patients after laparoscopic radical resection.Methods One hundred and twenty patients,who received laparoscopic surgery for colorectal and needed PCIA after the operation,were randomly assigned to two groups:the wireless monitoring group(group W,n=60) and the conventional PCIA group(group P,n=60).The use of analgesia pumps started after tracheal extubation;pain rating VAS was scored at 2,6,12,24,48 h after PCIA started and the comfort status score after PCIA was assessed for 3 d.The daily dose of analgesics,the times of additional analgesia demanded,the times of pain management by medical staff,the total number and effective number of the PCIA pressing,the analgesia related complications,the satisfaction of patients and medical staff were documented in two groups.Results Compared with group P,the pain rating VAS was lower in group Wat 6 h in resting state(P<0.05),and at 2 h,6 h in active state(P<0.05);the comfort status score for 3 d of PCIA was higher in group W(P<0.05).Analgesic dosage of group Wwas higher than that of group P in the first 24 h(P<0.05).The pain management time by medical staff in group Wwas significantly shorter than that in the group P(P<0.01).The total pressing number of PCIA in group Wwas less than that in group P(P<0.05).After 48 h of PCIA treatment,satisfaction of patients and medical staff were higher in group W(P<0.05).Conclusion Compared with the conventional analgesia pump,the wireless remote patient-controlled intravenous analgesia monitoring system can more effectively control the pain,accelerate the early recovery,increase the comfort status and satisfaction of colorectal cancer patients after laparoscopic radical resection.
引文
[1]郑民华.腹腔镜手术-结直肠癌根治性手术金标准?[J].中国实用外科杂志,2012,32(9):731-733.
[2]孙正怡,冷金花,郎景和.腹腔镜手术后疼痛[J].中国现代手术学杂志,2000,4(4):309-311.
[3]Diaz G,Flood P.Strategies for effective postoperative pain management[J].Minerva Anestesiol,2006,72(3):145-150.
[4]周燕艳.术后急性疼痛治疗的新进展[J].临床药物治疗杂志,2012,10(5):34-38.
[5]Ochroch EA,Gottschalk A.Impact of acute pains and its management for thoracic surgical patients[J].Thorac Surg Clin,2005,15(1):105-121.
[6]Chou R,Gordon DB,de Leon-Casasola OA,et al.Management of Postoperative Pain:A Clinical Practice Guideline From the American Pain Society,the American Society of Regional Anesthesia and Pain Medicine,and the American Society of Anesthesiologists'Committee on Regional Anesthesia,Executive Committee,and Administrative Council[J].J Pain,2016,17(2):131-157.
[7]Correll DJ,Vlassakov KV,Kissin I.No evidence of real progress in treatment of acute pain,1993-2012:scientometric analysis[J].JPain Res,2014,7:199-210.
[8]何苗,冯艺,陈杰,等.无线远程镇痛泵监控系统用于术后患者镇痛管理的可行性及有效性研究[J].中国疼痛医学杂志,2014,20(5):308-313.
[2]孙正怡,冷金花,郎景和.腹腔镜手术后疼痛[J].中国现代手术学杂志,2000,4(4):309-311.
[3]Diaz G,Flood P.Strategies for effective postoperative pain management[J].Minerva Anestesiol,2006,72(3):145-150.
[4]周燕艳.术后急性疼痛治疗的新进展[J].临床药物治疗杂志,2012,10(5):34-38.
[5]Ochroch EA,Gottschalk A.Impact of acute pains and its management for thoracic surgical patients[J].Thorac Surg Clin,2005,15(1):105-121.
[6]Chou R,Gordon DB,de Leon-Casasola OA,et al.Management of Postoperative Pain:A Clinical Practice Guideline From the American Pain Society,the American Society of Regional Anesthesia and Pain Medicine,and the American Society of Anesthesiologists'Committee on Regional Anesthesia,Executive Committee,and Administrative Council[J].J Pain,2016,17(2):131-157.
[7]Correll DJ,Vlassakov KV,Kissin I.No evidence of real progress in treatment of acute pain,1993-2012:scientometric analysis[J].JPain Res,2014,7:199-210.
[8]何苗,冯艺,陈杰,等.无线远程镇痛泵监控系统用于术后患者镇痛管理的可行性及有效性研究[J].中国疼痛医学杂志,2014,20(5):308-313.