围术期规范化疼痛管理对全膝关节置换术后疼痛的控制效果

Effect of postoperative pain control after total knee arthroplasty with perioperative standardized pain management

目的探讨围术期规范化疼痛管理对全膝关节置换（TKA）术后疼痛控制的效果。方法选择全膝关节置换术患者60例，按照随机原则分为研究组和对照组，每组30例。对照组予骨科常规护理，研究组实施围术期规范化疼痛管理，对比2组患者术后不同时间点的疼痛程度、Ramsay镇静评分，并比较2组的不良反应、患者对疼痛管理的满意度。结果研究组在术后48h内疼痛评分均低于对照组（P〈0．05），对疼痛管理的满意度高于对照组（P〈0．05），不良反应低于对照组（P〈0．05），Ramsay镇静评分2组差异无统计学意义（P〉0．05）。结论通过完善疼痛评估体系，制定个体化、多元化、分阶梯镇痛治疗方案，规范围术期的疼痛管理，能够有效地缓解全膝关节置换患者的术后疼痛，提高患者疼痛管理满意度，提高临床护理质量，促进患者康复。

Objective To investigate the effect of postoperative pain control after total knee arthroplasty （TKA） with perioperative standardized pain management. Methods 60 patients undergoing TKA were randomlv divided into two groups. One was study group and another was control group （n = 30 each）. Control group received orthopedic routine nurs- ing care, study group received perioperative standardized pain management. The degree of pain and sedation in different time period, adverse reactions and satisfaction to pain management were compared between the two groups. Results The comparison of degree of pain after operation showed that pain score within 48 hours of patients in study group was lower than that in control group （P 〈 0.05 ）. The difference of sedation score was not statistically significant （P 〉 0.05 ）, while the adverse reactions of study group were lower than control group and satisfaction degree with pain control was higher （ P 〈 0. 05 ）. Conclusions The approvment of pain assessment system, the fortmflation of individualized, multi - mode, ladder an- algesic regimen scheme, and the standardization of perioperative pain management, all of which can effectively reduce postop- erative pain of TKA, promote the improvement of nursing quality and satisfaction of patients, accelerate their recovery.