静脉穿刺痛预测妇科开腹手术后急性疼痛的准确性

Accuracy of acute pain prediction after gynecological laparotomy from the assessment of pain associated with venipuncture

目的评价手背静脉穿刺痛预测妇科开腹手术后疼痛程度的准确性。方法选取择期行妇科开腹手术的患者80例,根据术前静脉穿刺的视觉模拟(VAS)评分将患者分为低应答(L)组(VAS<4分)和高应答(H)组(VAS≥4分)。观察并记录2组术后24 h内最大VAS评分、首次自控镇痛距手术结束的时间及24 h内镇痛泵按压次数。结果与L组相比,H组术后VAS评分显著提高(P<0.05),首次自控镇痛时间提前(P<0.05),镇痛泵按压次数增加(P<0.05)。术前静脉穿刺痛与术后24 h内最大VAS评分呈显著正相关(r=0.40,P<0.001),与首次自控镇痛距手术结束的时间呈显著负相关(r=-0.406,P<0.001),与自控镇痛次数相关性弱(r=0.294,P<0.01)。术前静脉穿刺痛预测术后疼痛的灵敏度为86%,特异度为70%。结论静脉穿刺痛是预测妇科开腹手术后急性疼痛的可靠方法。

Objective To evaluate the accuracy of acute pain prediction after gynecological laparotomy based on the assessment of pain associated with venipuncture.Methods A total of 80 patients who underwent elective gynecological laparotomy was enrolled in this study.The pain associated with venipuncture was assessed using visual analogue scales(VAS),according to which the patients were grouped into group L(VAS<4)and group H(VAS≥4).The pain intensity 24 h postoperatively,and time to first pressing and pressing times of analgesic pump were recorded.Results Compared with group L,the patients in group H reported higher postoperative pain intensity(P<0.05)and pressed the analgesic pump earlier(P<0.05)and more frequently(P<0.05).There was a significant correlation between venipuncture pain and pain intensity 24 h postoperatively(r=0.40,P<0.001)and time to first pressing of analgesic pump(r=0.406,P<0.001),while the correlation between venipuncture pain and pressing times of analgesic pump was weak(r=0.294,P<0.01).The sensitivity and specificity of venipuncture pain assessment to predict acute postoperative pain were 86%and 70%,respectively.Conclusion The pain associated with venipuncture is reliable in predicting acute pain after gynecological laparotomy.