播放音乐对腹腔镜胆囊切除术患者麻醉后恢复的影响

The effect of music therapy in postanesthesia care unit on the postoperative outcomes after laparoscopic cholecystectomy

目的观察在麻醉恢复室(PACU)中播放背景音乐对全麻下行腹腔镜胆囊切除术患者术后恢复质量的影响。方法择期全麻下腹腔镜胆囊切除术患者40例,美国麻醉医师协会分级Ⅰ或Ⅱ级,年龄30-64岁,随机分为干预组和对照组,每组20例。在PACU中为干预组患者播放背景音乐,对照组不播放任何音乐,两组患者手术由同一组医生完成,所用麻醉方法、麻醉药物及术后镇痛方法相同。记录术前、入PACU即刻、入PACU后1h和离开PACU时血清皮质醇浓度、心率、平均动脉压;评估入PACU即刻、入PACU后1h和离开PACU时的VAS评分;记录PACU中吗啡总用量、镇痛泵使用情况、患者满意度、PACU停留时间和恶心、呕吐、尿路刺激征等不良反应的发生率。结果与对照组相比,干预组入PACU后1h和离开PACU时血清皮质醇浓度和VAS评分降低(P<0.05);入PACU后1h干预组的心率和平均动脉压低于对照组(P<0.05);干预组吗啡总用量、镇痛泵总按压次数和有效次数均低于对照组,而患者满意度提高(P<0.05);两组PACU停留时间和不良反应发生率的差异无统计学意义(P>0.05)。结论在PACU中播放背景音乐有利于缓解全麻下腹腔镜胆囊切除术患者的术后疼痛,提高患者满意度。

Objective To evaluate the effect of music therapy in postanesthesia care unit （PACU） on the patients＇ recovery after laparoscopic cholecystectomy. Methods Forty patients scheduled for laparoscopic cholecystectomy under general anesthesia were randomly divided into music therapy group in PACU and control group. The surgical technique,anesthesia and use of postoperative patient controlled intravenous analgesia （PCIA） were standardized. The level of serum cortisol,heart rate（HR） and mean arterial pressure （MAP） were recorded before operation,at PACU arrival,1h after PACU arrival and at discharged from PACU. The score of visual analog scale （VAS）,total morphing consumption,total times and practice times of PCIA use, patients＇ satisfaction,the duration of PACU stay and the occurrence of nausea,vomiting,urinary problems were recorded during PACU stay. Results Compared with the control group,the serum cortisol level and score of VAS in music therapy group were significantly lower at 1h after PACU arrival and at discharged from PACU（P0.05）,the HR and MAP were also lower at 1h after PACU arrival（P0.05）. The total morphing consumption,total times of PCIA use,practice times of PCIA use were signif-icantly lower in the music therapy group （P0.05）,while patients＇ satisfaction level was higher （P0.05）. No difference was found on the duration of PACU stay and the occurrence of nausea,vomiting,urinary problem （P0.05）. Conclusion The music therapy in PACU may relieve postoperative pain and increase patients＇ satisfaction after laparoscopic cholecystectomy.