智能化病人自控镇痛对术后镇痛患者不良反应与满意度的影响

Effects of artificial intelligent patient-controlled analgesia on the adverse reactions and satisfaction for postopera-tive patients

目的探讨智能化病人自控镇痛(Ai-PCA)在手术后疼痛管理中对患者不良反应与满意度的影响.方法选择择期实施外科手术并自愿使用术后镇痛泵的患者5700例,按照1:2的比例随机分为PCA组和Ai-PCA组.PCA组(n=1612)术后应用常规病人自控镇痛管理模式进行疼痛管理,Ai-PCA组(n=3674)术后加用Ai-PCA系统信息监控结果进行疼痛管理.观察两组患者中重度疼痛(NRS≥4)的发生率,恶心呕吐、过度镇静、瘙痒、头晕、呼吸抑制等不良反应和患者的满意率.结果Ai-PCA组患者术后中重度疼痛发生率低于PCA组(P<0.01),且Ai-PCA组患者恶心呕吐、瘙痒、头晕的发生率均低于PCA组(P<0.05);两组均无患者发生呼吸抑制,Ai-PCA组患者的镇痛满意率显著高于PCA组(P<0.01).Ai-PCA系统预测中重度疼痛(NRS≥4)发生的敏感度为90%(62/69)、特异度为89%(3201/3605).结论Ai-PCA系统能够减少镇痛不全、术后恶心呕吐等不良反应,并显著提升患者的满意程度,可在临床选用.

Objective To investigate the effect of artificial intelligent patient-controlled analgesia(Ai-PC A)on the adverse reactions and satisfaction for postoperative pain management.Methods There were 5700 patients who underwent surgery and voluntarily used analgesia pump.They were randomly divided into traditional PCA group and Ai-PCA group on a scale of 1-2.The PCA group(n=1612)only received the traditional pain management mode,while the Ai-PCA group(n=3674)received additional Ai-PCA system for pain management.The incidence of moderate and severe pain(NRS≥≥4),adverse reactions(nausea and vomiting,excessive sedation,pruritus,dizziness,respiratory depression)and the satisfaction rate of patients were observed.Results The incidence of moderate and severe postoperative pain in Ai-PCA group was significantly lower than that in PCA group(P<0.01),so was the incidence of nausea,vomiting,pruritus and dizziness(P<0.05).There was no respiratory depression in both groups,but the satisfaction rate of patients in Ai-PCA group was significantly higher than that in PCA group(P<0.01).The sensitivity and specificity of the Ai-PCA system in predicting moderate and severe pain(NRS≥4)were 90%(62/69)and 89%(3201/3605),respectively.Conclusion Ai-PCA system reduces the adverse reactions such as insufficient analgesia,PONV,and significantly improves the satisfaction of patients,which can be used in clinical practice.