多学科合作疼痛管理模式在剖宫产患者疼痛管理中的应用效果

Effect of pain management model of the multidisciplinary cooperation in patients undergoing cesarean section

目的评价以产科护士和麻醉科护士为基础,麻醉医生为督导,产科医生共同参与的多学科合作疼痛管理模式对剖宫产患者疼痛管理的效果。方法选取我院2019年5~6月择期行剖宫产手术的患者354例为研究对象,随机分为干预组(n=178)和对照组(n=176),最终350例患者完成研究,其中干预组176例,对照组174。干预组给予以产科护士和麻醉科护士为基础,麻醉医生为督导,产科医生共同参与的多学科合作疼痛管理模式;对照组由产科护士和产科医生实施术后镇痛管理。比较2组患者术后镇痛效果、术后生理功能恢复情况及患者对术后疼痛管理效果的满意度。同时评价多学科合作疼痛管理模式对产科护士疼痛知识和态度的影响。结果干预组患者在术后疼痛评分、术后疼痛NRS评分最大值、最大疼痛评分持续时间及疼痛评分>3分的持续时间上均低于对照组(P<0.05);干预组患者在首次下床活动时间低于对照组(P<0.05);干预组患者术后48h内睡眠时间长于对照组(P<0.05);干预组患者的术后镇痛效果满意度优于对照组(P<0.05);开展多学科合作疼痛管理模式后,产科护士疼痛管理知识和态度水平高于实施前(P<0.05)。结论以产科护士和麻醉科护士为基础,麻醉医生为督导,产科医生共同参与的多学科合作疼痛管理模式有效地降低了剖宫产患者术后疼痛水平,有利于患者生理功能的恢复,提高了患者对术后镇痛效果的满意度,同时提升了产科护士的疼痛管理水平。

Objective To evaluate the effect of pain management model of the multidisciplinary cooperation based on obstetrics nurses and anesthesiology nurses,supervised by anesthesiologists,and participated by obstetricians on postoperative pain management in patients undergoing cesarean section.Methods A total of 354 patients scheduled for cesarean section in the Second Affiliated Hospital of Anhui Medical Hospital from May 2019 to June 2019,were selected and randomly divided into two groups:interventional group ( n =178) and control group ( n =176).Eventually,350 patients completed the study including 176 patients in interventional group and 174 patients in control group.The interventional group was given pain management model of the multidisciplinary cooperation based on obstetrics nurses and anesthesiology nurses,supervised by anesthesiologists,and participated by obstetricians.The control group was given customary acute pain service.The effect of postoperative pain management,postoperative function recovery and patients' satisfaction with postoperative pain management were collected.At the same time,the effects of multidisciplinary pain management model on pain knowledge and attitudes of obstetric nurses were evaluated.Results In the interventional group,the maximum postoperative pain score,average postoperative pain score,duration of maximum pain score and duration of pain score greater than 3 points were all lower than those in the control group ( P <0.05).In the interventional group,the time of first ambulation was shorter than that in the control group ( P <0.05).The sleep duration of the interventional group was longer than that of the control group within 48 h after operation.The satisfaction of postoperative analgesic effect of the interventional group was better than that of the control group.The knowledge on pain management and attitude scores of obstetric nurses were higher than before the implementation of the multidisciplinary pain management model.Conclusion The pain management model of the multidisciplinary cooperation based on obstetrics nurses and anesthesiology nurses,supervised by anesthesiologists,and participated by obstetricians can effectively reduce the pain level of patients after cesarean section.It is beneficial to the recovery of patients’ physiological functions and can improve the satisfaction with effective postoperative pain management.Meanwhile,the pain management level of obstetrics nurses can also be improved.