国际麻醉学与复苏杂志   2017, Issue (10): 0-0
    
无线远程镇痛泵监控系统结合自控镇痛宣教在胸科手术后镇痛中的应用
陈斌, 陈伟, 胡北, 饶丽华1()
1.南京鼓楼医院集团宿迁市人民医院
Application of wireless remote analgesic pump monitoring system combined with education on patient-controlled analgesia in the analgesia after thoracic surgery
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摘要:

目的 探讨无线远程镇痛泵监控系统结合自控镇痛宣教在胸科手术后镇痛中的应用效果。 方法 选择60例胸腔镜下食管癌根治术、肺癌根治术患者,按随机数字表法分为无线远程镇痛泵监控系统组(Ⅰ组)和普通电子镇痛泵组(Ⅱ组),每组30例。Ⅰ组采用无线镇痛泵监控系统进行术后镇痛并选择多个时间点对患者及其家属进行术后镇痛宣教,Ⅱ组采用普通电子镇痛泵。记录术后4、8、12、24、48 h的疼痛数字评分(numerical rating scale, NRS)、使用镇痛泵后患者满意度评分和麻醉医师被动回访率等。 结果 与Ⅱ组比较,Ⅰ组4、8、12、24 h的NRS评分均较低(P<0.05);麻醉医师被动回访率Ⅰ组3例占10%、Ⅱ组13例占43.3%(P<0.05);Ⅰ组通过远程数据监测发现报警信息8次,Ⅱ组接到病房反馈镇痛不足有13次,至病房进行有效处理的时间Ⅰ组(9±3) min、Ⅱ组(13±7) min(P<0.05);Ⅰ组术后4、8、12、24 h的患者满意度评分高于Ⅱ组(P<0.05)。 结论 无线远程镇痛泵监控系统结合宣教在胸科手术后镇痛中的应用可以为患者实施个体化镇痛管理,改善了镇痛效果,提高了患者的满意度。

关键词: 无线远程镇痛泵监控系统; 自控镇痛; 患者满意度
Abstract:

Objective To investigate the efficacy of wireless remote analgesic pump monitoring system combined with education on patient-controlled analgesia in the analgesia after thoracic surgery. Methods Sixty patients undergoing thoracoscopic-assisted radical resection for esophageal carcinoma or lung cancer were selected and based on the random number table method were randomly divided into group Ⅰ and groupⅡ (n=30). Patients in group Ⅰ were provided with postoperative analgesia using wireless remote analgesic pump monitoring system, while the patients and their families were educated about postoperative analgesia at different time points. Those in group Ⅱ was given general electronic analgesia pumps alone. Then, numerical rating scale (NRS) scores 4, 8, 12, 24 h and 48 h after surgery, the rate of passive visit of anesthesiologists, and the satisfaction score of patients after analgesic pump use at each time point were recorded. Results Compared with group Ⅱ, the NRS scores at 4, 8, 12, 24 h in groupⅠ were declined (P<0.05). Passive visit was conducted by anesthesiologists for 3 patients (10%) in group I and 13 patients (43.3%) in group Ⅱ (P<0.05). Alarm was detected by remote data monitoring for 8 times in group I, while feedback about inadequate analgesia from the ward was reported for 13 times in group Ⅱ. The duration of effective treatment in the ward was (9±3) min for group Ⅰ and (13±7) min for group Ⅱ (P<0.05). The degree of satisfaction was higher in group Ⅰ than that in group Ⅱ 4, 8, 12 h and 24 h after surgery (P<0.05). Conclusions The combined use of wireless remote analgesic pump monitoring system and education on postoperative analgesia among patients and their families after thoracic surgery provides individualized anesthetic management, which improves analgesic effect and patients' satisfaction.

Key words: Wireless remote analgesic pump monitoring system; Patient-controlled analgesia; Patients' satisfaction