目的 了解住院患者疼痛控制结局的现状及对疼痛控制的满意度，为疼痛管理提供依据。 方法 2012年5月运用便利抽样法选取206例住院患者为研究对象，采用调查问卷的方式了解患者疼痛管理现状和满意度。调查工具为自行设计的患者基本信息调查表、美国疼痛协会结局问卷修订量表。 结果 调查对象当前、过去24 h内最剧烈的疼痛程度及疼痛平均水平以轻度为主，分别占43.2%、42.2%、40.3%；疼痛对一般活动、情绪和其他康复活动的影响程度以中度为主，分别占52.4%、58.3%、53.4%；对疼痛处理结果的满意度以一般为主，占40.8%；78.6%的患者在入院时未被告知疼痛治疗的重要性；66.5%～84.5%的患者对疼痛和止痛药的认知均较差。 结论 二级医院住院患者的疼痛程度较轻，其对生活影响程度尚不严重，但患者对疼痛控制的满意度欠佳，对疼痛相关知识的认知也较差，急需医护人员采取相应的措施提高疼痛控制的效果和质量，从而提高患者在住院期间的满意度。
Nevus flammeus is a skin disease caused by congenital skin capillary malformation. In recent years, photodynamic therapy (PDT) has been proved to be effective and safe for this disease, but significant pain in the treatment process is the biggest obstacle to the implementation of this therapy. This article reviews the current pain management strategies in PDT. The current pain management methods include topical anesthesia, cold air analgesia, nerve block and others. Topical anesthesia has weak analgesic effect and short duration in PDT. Cold air analgesia is simple and feasible, but there is potential risk of affecting the treatment effect. The analgesic effect of nerve block is accurate, but the application scenario is limited. For nevus flammeus patients who need PDT, individualized analgesia should be selected according to the patient’s age and treatment scenario.
Objective To investigate the effects of pain specialist nurse training (PSNT) on nurse’s pain management knowledge and attitude. Methods By distributing the “questionnaire of pain management knowledge and attitude”, 95 certified nurses, who were from 24 hospitals of different levels in Sichuan, Chongqing, Yunnan and Xinjiang, were investigated to survey their knowledge and attitude changes before and after PSNT. The data were analyzed by t-test. Results A total of 190 questionnaires were distributed to 95 nurses, and 190 returned, with a effective response rate of 100%. The result showed that, the total score after training (34.00±5.30) was significantly higher than that before training (17.58±4.00), with a significant difference (P=0.000). Conclusion The pain specialist nurse training can improve nurses’ knowledge and their attitudes on pain management.
ObjectiveTo explore the knowledge and attitude of pain management in undergraduate nursing students, analyze the influencing factors, and improve the future education of the undergraduate nursing students. MethodsA total of 220 undergraduate nursing students were investigated with the Knowledge and Attitudes Survey Regarding Pain between November 2014 to June 2013. ResultsUndergraduate nursing students were lack of cognition on pain management and attitude, with an average wrong answer rate of 55.70%; the difference in reading related books or journals in pain, pain management training, and frequency of usage of pain assessment tools among the influential factors were significant (P < 0.05). The most common factor was the lack of pain management training. ConclusionsThe knowledge level of pain management in undergraduate nursing students who are lack of pain management training needs to be improved. Medical schools might optimize pain management courses, and hospitals should enhance the pain management training of clinical nurses so as to make them assess patients correctly by using pain assessment tools. In addition, it's necessary to enhance the nursing students' pain management practice during the clinical practice, so as to improve the pain management knowledge level in undergraduate nursing students.
ObjectiveTo explore the role of fast-track surgery (FTS) in day-case laparoscopic cholecystectomy (DLC) pain management. MethodsWe used bidirectional cohort study to investigate the patients undergoing day surgery of laparoscopic cholecystectomy admitted into our department. A total of 143 patients between April and September 2014 receiving routine pain management were chosen to be the control group, and 78 patients between October 2014 and January 2015 receiving FTS pain management were regarded as the FTS group. Postoperative pain, early ambulation, influence of pain on the sleep, patients' satisfaction and prolonged hospital stay rate were compared between the two groups. ResultsPain scores of patients in the FTS group 0-0.5, 0.5-6, 6-12, and 12-24 hours after surgery were significantly lower than those in the control group (P<0.05). The proportion of patients with early postoperative ambulation and patients' satisfaction rate in the FTS group were significantly higher than the control group (P<0.05). ConclusionThe FTS pain management model can effectively reduce patients' pain after DLC, accelerate patients' postoperative rehabilitation and increase patients' satisfaction.
目的 探讨“医护一体化”疼痛管理模式在骶骨肿瘤患者围手术期的应用效果。 方法 以2011年1月－10月选取的23例骶骨肿瘤患者作为研究对象，根据科室疼痛管理的规范化流程，在“医护一体化”工作模式下由护士进行疼痛评估、医生护士共同制定疼痛管理方案，护士落实个体化疼痛护理措施、规范用药指导、综合心理护理和镇痛效果反馈等。 结果 经“医护一体化”疼痛管理，患者疼痛情况大为改观，20例患者疼痛评分＜3分，占总例数的87.0%，由入院初期的中、重度疼痛患者居多转变为轻度疼痛患者占主导。 结论 运用医护一体化多模式疼痛管理可以有效减轻患者疼痛，提高护理服务质量。
Objective To investigate the effect of intravenous analgesia with a wireless or traditional analgesia pump system in thoracoscopic lung resection.MethodsPatients who used the patient-controlled intravenous analgesia after thoracoscopic lung resection between June 2016 and June 2021 were enrolled in the study. They were allocated into a wireless pump group (a ZigBee-based wireless analgesia pump system collecting data automatically) and a traditional analgesia pump group. Perioperative analgesia management followed the routine standard operation protocol of Shanghai Chest Hospital. The patients’ numeric rating scale (NRS) for pain and postoperative nausea and vomiting (PONV) scores were collected for analysis from the Anesthesia Information Record System. The incidence of postoperative analgesia insufficiency (defined as NRS≥4 points) within 48 h, the incidence of PONV within 24 h, and the 48 h completion rate of analgesia pump infusion were compared. ResultsA total of 59431 patients were collected, including 24855 males and 34576 females, 17209 patients in the wireless pump group, and 42222 patients in the traditional analgesia pump group. The incidence of analgesia insufficiency within 48 h after operation (3.75% vs. 4.98%, P=0.007), the incidence of PONV within 24 h after operation (13.60% vs. 16.70%, P=0.030) in the wireless pump group were lower than those in the traditional analgesia pump group. The 48 h completion rate of analgesia pump infusion in the wireless pump group was higher than that in the traditional analgesia pump group (83.40% vs. 71.90%, P<0.001). The wireless pump group could monitor the pressing times and use of the analgesia pump, while the traditional analgesia pump group could not record the relevant data. ConclusionCompared with the traditional analgesia pump, the wireless analgesia management system may be convenient for timely, accurate and individualized management, and has good analgesic effect and low incidence of adverse reactions, and may be more suitable for perioperative analgesia management.
Enhanced recovery after surgery (ERAS) is a protocol designed to improve perioperative outcomes by multidisciplinary team with evidence-based interventions. The implementation of ERAS concept has been proved to reduce postoperative complications and hospital stay. The anesthesia management under the concept of ERAS is the basis of safe and smooth ambulatory surgical protocol. This article summarizes the latest clinical evidence at home and abroad, and reviews the preoperative optimization, anesthesia mode selection, ventilation strategies, fluid management, temperature support, pain management, postoperative nausea and vomiting prevention, postoperative nutritional support, and postoperative sleep improvement in the management of anesthesia under ERAS concept, in order to provide a reference for anesthesia management in ambulatory surgery.