麻醉护士围术期疼痛管理对剖宫产产妇术后自控镇痛的影响

Impact of anesthesia nurse perioperative pain management on the patient-controlled analgesia after cesarean section

目的观察麻醉护士协助麻醉医师对接受剖宫产产妇进行围术期疼痛管理对产妇术后镇痛的影响。方法将拟实施择期剖宫产并且愿意接受术后镇痛的单胎活产孕产妇120例。随机分为麻醉护士协助管理组(N组)与传统的麻醉医师负责组(A组)各60例。N组产妇入院后,由麻醉护士协助医师进行疼痛学宣教,术中麻醉护理及术后随访等;而A组则仅由麻醉医师进行围术期疼痛管理。麻醉方式为腰麻。2组患者术毕均接静脉电子镇痛泵。疼痛评估采用视觉模拟评分(VAS)观察2组产妇人口学资料,24h内随访时点的VAS评分及产妇满意度评分。结果所有产妇均完成术后镇痛治疗,未见呼吸抑制,活动障碍等严重并发症,无退出病例。2组产妇的一般情况差异无统计学意义(P>0.05)。N组术后4h、8h时间点的VAS评分明显低于A组,差异有统计学意义(P<0.05),其余时点2组VAS评分则无统计学差异(P>0.05)。N组产妇满意度明显高于A组,差异有统计学意义(P<0.05)。结论围术期麻醉护士积极加入疼痛管理可有助于剖宫产产妇术后的疼痛治疗,产妇对术后镇痛的满意度更高。

Objective To investigate the impact of anesthesia nurse perioperative pain management on the patientcontrolled analgesia after cesarean section. Methods Selected intending to perform cesarean section,willing to accept postoperative analgesia,single live births maternal 120 cases,randomly divided into anesthesia nurses to assist management group（ N group） and anesthesiologist responsible group（ A group）,each of 60 cases. N group was given with pain education,intraoperative anesthesia care and postoperative follow-up,assisted by anesthesia nurse for physician. A group was given with perioperative pain panagement by anesthesiologists. Anesthesia methods was spinal anesthesia. Received intravenous electronics analgesia pump after surgery of two groups. Pain was assessed using a visual analog scale（ VAS）,observed maternal demographic data of two groups,24 h follow-up VAS and maternal satisfaction scores. Results Two groups completed postoperative analgesia,no respiratory depression and movement disorder serious complications,no exit cases. General difference between the two groups were not statistically significant（ P〉0. 05）. The VAS score 4h,8h of N Group after surgery was significantly lower than that in A group,the difference was statistically significant（ P〈0. 05）,the remaining point of two groups had no significant difference in VAS score（ P〉0. 05）. The maternal satisfaction of N group was significantly higher than A group,the difference was statistically significant（ P〈0. 05）. Conclusion The perioperative actively participated in pain management by anesthesia nurses can contribute to maternal early postoperative pain therapy,and higher maternal satisfaction postoperative analgesia.