无线镇痛泵联合急性疼痛服务体系在骨科患者术后镇痛管理的应用

Application of wireless analgesia pump combined with acute pain service system in postoperative analgesia management of orthopaedic patients

目的探究无线镇痛泵(PCIA)联合急性疼痛服务体系(APS)在骨科患者术后镇痛管理中的应用效果。方法选择2017年9月—2018年6月我院骨科术后患者152例作为研究对象,随机分为观察组和对照组两组,每组各76例。观察组患者采用无线镇痛泵联合APS体系进行术后镇痛,对照组采用传统的电子镇痛泵进行术后镇痛,两组患者以首次负荷量+持续给药量+静脉自控给药48 h。对比两组患者静脉自控镇痛后2 h、12 h、24 h、48 h疼痛数字评价量表(NRS)评分,疼痛处理时间和自控镇痛按键总次数及有效次数,镇痛药物不良反应以及镇痛满意度。结果观察组患者在PCIA后2 h与对照组NRS评分无明显差异(P>0.05); PCIA后12 h、24 h、48 h,观察组患者NRS评分明显低于对照组(P<0.05)。观察组患者疼痛处理时间明显低于对照组患者(P<0.05);两组自控镇痛按键总次数及有效次数无明显差异(P>0.05)。两组患者出现恶心呕吐、头晕、呼吸抑制、皮肤瘙痒等镇痛药物不良反应无明显差异(P> 0.05)。观察组患者的护理满意度(72例满意,91.48%)明显高于对照组患者的护理满意度(53例满意,55.32%)(P<0.05)。结论无线镇痛泵联合APS体系应用于骨科术后镇痛,安全可行,有助于提高镇痛管理质量,值得临床推广。

Objective To explore the application effect of wireless analgesia pump combined with Acute Pain Services(APS)system in postoperative analgesia management of orthopedic patients.Methods From March 2015 to September 2017,a total of 152 orthopedic postoperative patients in our hospital were selected.They were randomly divided into observation group and control group,76 cases each.The patients in the observation group were treated with wireless analgesia pump combined with APS system for postoperative analgesia.The control group was treated with a traditional electronic analgesia pump for postoperative analgesia.The patients in the two groups were given first dose,continuous dose,and self controlled intravenous dose for 48 hours.The scores of numerical rating scale(NRS)at 2 h,12 h,24 h,and 48 h after patient-controlled intravenous analgesia(PCIA)in the two groups were compared.As well as the pain treatment time,and the total number and effective times of the patient-controlled analgesia keys,pain drug adverse reactions and analgesic satisfaction.Results There was no significant difference in NRS scores between the observation group and the control group at2 h after PCIA(P>0.05).The NRS scores of the observation group were significantly lower than those of the control group at 12 h,24 h,and 48 h after PCIA(P<0.05).The pain treatment time in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the total number of times and effective times of the automatic control analgesia between the two groups(P>0.05).There was no significant difference in adverse reactions such as nausea and vomiting,dizziness,respiratory depression,and pruritus induced by analgesic drugs between the two groups(P>0.05).The satisfaction of patients in the observation group(72 cases,91.48%)was significantly higher than that of the control group(53 cases,55.32%),P<0.05.Conclusions The application of wireless analgesia pump and APS system in postoperative analgesia in orthopaedics is safe and feasible,which helps to improve the quality of analgesia management and worthy of clinical promotion.