Application of multi-scale digital scoring scale in patient-controlled intravenous analgesia after thoracotomy

Xue QIN; Juan LIU; Kaizhi LU; Li WANG

doi:10.16016/j.1000-5404.201802055

您当前的位置：

首页 >

文章列表页 >

Application of multi-scale digital scoring scale in patient-controlled intravenous analgesia after thoracotomy

更新时间：2026-01-09

- Application of multi-scale digital scoring scale in patient-controlled intravenous analgesia after thoracotomy
- Journal of Third Military Medical University Vol. 40, Issue 16, Pages: 1518-1522(2018)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201802055
  CLC：
- Received：07 February 2018，
  
  Published：30 August 2018
- 稿件说明：
移动端阅览
Xue QIN, Juan LIU, Kaizhi LU, et al. Application of multi-scale digital scoring scale in patient-controlled intravenous analgesia after thoracotomy[J]. Journal of Third Military Medical University, 2018, 40(16): 1518-1522.
DOI：

Xue QIN, Juan LIU, Kaizhi LU, et al. Application of multi-scale digital scoring scale in patient-controlled intravenous analgesia after thoracotomy[J]. Journal of Third Military Medical University, 2018, 40(16): 1518-1522. DOI： 10.16016/j.1000-5404.201802055.

摘要

Abstract

Objective

To assess the application of multi-scale digital scoring scale in patient-controlled intravenous analgesia (PCIA) after thoracotomy.

Methods

Seventy-four patients undergoing elective thoracotomy were equally randomized into control group and multi-scale digital scoring scale group (group M).In group M

Visual Analog Scale (VAS)

Ramsay sedation score

Bruggrmann comfort scale (BCS)

nausea and vomiting scale and the degree of respiratory depression were evaluated before the patients were transferred to the intensive care unit and every 2 h after the surgery

and the maintenance dose and single dose for PCIA were adjusted based on the results of the evaluations.In the control group

PCIA was administered at the preset maintenance dose and single dose without dose adjustment.The default PCIA formulation included sufentanil (300 μg)

flurbiprofen axetil (200 mg)

and tropisetron (15 mg)

all diluted in 300 mL normal saline for continuous pump infusion at 3 mL/h with a single dose of 2 mL and a lock time of 15 min.At 2

24 and 48 h after the surgery

the VAS score

Ramsay sedation score

and Bruggrmann comfort scale were evaluated for each patient and the incidences of adverse reactions were recorded.At each of these selected observation points

analgesic consumption and the number of times of button presses were recorded

and the overall satisfaction of the patients was assessed.

Results

No significant difference was found in resting VAS score between the 2 groups at each of the observation points (

0.05).Compared with the control group

group M had significantly lower times of button presses during PCIA (

0.05)

significantly lower VAS scores during exercise at 2 and 4 h

and significantly higher BCS scores at 2

4 and 8 h (

0.05).The Ramsay sedation score was significantly higher at 2 h but was lower at 48 h in group M than in the control group (

0.05).Compared with that in the control group

analgesic consumption at 2 h was significantly increased (

0.05) but lowered significantly at 4

and 48 h (

0.05) in group M; the overall satisfaction rate was significantly higher in group M (

0.05).No significant difference was found in the incidence of adverse reactions between the 2 groups at 48 h after the operation.In the control group

2 patients experienced vertigo and 3 had nausea and vomiting; 3 patients in group M reported dizziness and 2 had nausea and vomiting during PCIA.None of the patients in the 2 groups complained of skin pruritus during PCIA.

Conclusion

Compared with routine PCIA

PCIA with dose adjustment based on evaluation with the multi-scale digital scoring scale achieves more effective and safer postoperative analgesia and better overall satisfaction in patients following thoracotomy.

关键词

Keywords

references

HWANG E G LEE Y Effectiveness of intercostal nerve block for management of pain in rib fracture patients J Exerc Rehabil 2014 10 4 241 244 10.12965/jer.140137 HWANG E G, LEE Y.Effectiveness of intercostal nerve block for management of pain in rib fracture patients[J].J Exerc Rehabil, 2014, 10(4):241-244.DOI:10.12965/jer.140137.

夏智群于泳浩王国林舒芬太尼诱发患者呼吸抑制的药效学与年龄因素的关系中华麻醉学杂志 2010 30 6 667 669 10.3760/cma.j.issn.0254-1416.2010.06.009 夏智群, 于泳浩, 王国林.舒芬太尼诱发患者呼吸抑制的药效学与年龄因素的关系[J].中华麻醉学杂志, 2010, 30(6):667-669.DOI:10.3760/cma.j.issn.0254-1416.2010.06.009.

XIA Z Q YU Y H WANG G L Relationship between pharmacodynamics of sufentanil-induced respiratory depression and age factors Chin J Anesth 2010 30 6 667 669 10.3760/cma.j.issn.0254-1416.2010.06.009 XIA Z Q, YU Y H, WANG G L.Relationship between pharmacodynamics of sufentanil-induced respiratory depression and age factors[J].Chin J Anesth, 2010, 30(6):667-669.DOI:10.3760/cma.j.issn.0254-1416.2010.06.009.

张瑞芹方先海崔晓光舒芬太尼术后静脉自控镇痛的量效关系哈尔滨医科大学学报 2006 5 409 411 10.3969/j.issn.1000-1905.2006.05.020 张瑞芹, 方先海, 崔晓光.舒芬太尼术后静脉自控镇痛的量效关系[J].哈尔滨医科大学学报, 2006(5):409-411.DOI:10.3969/j.issn.1000-1905.2006.05.020.

ZHANG R Q FANG X H CUI X G The relationship of dosage and efect of sufentanyl in PCIA in patients of diferent ages J Harbin Med Univ 2006 5 409 411 10.3969/j.issn.1000-1905.2006.05.020 ZHANG R Q, FANG X H, CUI X G.The relationship of dosage and efect of sufentanyl in PCIA in patients of diferent ages[J].J Harbin Med Univ, 2006 (5):409-411.DOI:10.3969/j.issn.1000-1905.2006.05.020.

LIN X ZHANG R XING J Flurbiprofen axetil reduces postoperative sufentanil consumption and enhances postoperative analgesic effects in patients with colorectal cancer surgery Int J Clin Exp Med 2014 7 12 4887 4896 http://europepmc.org/abstract/MED/25663985 LIN X, ZHANG R, XING J, et al .Flurbiprofen axetil reduces postoperative sufentanil consumption and enhances postoperative analgesic effects in patients with colorectal cancer surgery[J ] .Int J Clin Exp Med, 2014, 7(12):4887-4896.

柳娟赵丽丹张晴氟比洛芬酯复合舒芬太尼用于老年患者术后镇痛的效果临床麻醉学杂志 2011 27 4 317 319 http://d.old.wanfangdata.com.cn/Periodical/lcmzxzz201104001 柳娟, 赵丽丹, 张晴, 等.氟比洛芬酯复合舒芬太尼用于老年患者术后镇痛的效果[J].临床麻醉学杂志, 2011, 27(4):317-319.

LIU J ZHAO L D ZHANG Q Effects of flurbiprof-enaxefil combined with sufentanil for postoperative anal-gesia in elderly patients J Clin Anesth 2011 27 4 317 319 http://d.old.wanfangdata.com.cn/Periodical/lcmzxzz201104001 LIU J, ZHAO L D, ZHANG Q, et al .Effects of flurbiprof-enaxefil combined with sufentanil for postoperative anal-gesia in elderly patients[J ] .J Clin Anesth, 2011, 27(4):317-319.

LIU Z F CHAI X Q CHEN K Z Flurbiprofen axetil enhances analgesic effect of fentanyl associated with increase in β-endorphin levels J Anesth 2011 25 5 679 684 10.1007/s00540-011-1192-6 LIU Z F, CHAI X Q, CHEN K Z.Flurbiprofen axetil enhances analgesic effect of fentanyl associated with increase in β-endorphin levels[J].J Anesth, 2011, 25(5):679-684.DOI:10.1007/s00540-011-1192-6.

NIESTERS M DAHAN A KEST B Do sex differences exist in opioid analgesia? A systematic review and meta-analysis of human experimental and clinical studies Pain 2010 151 1 61 68 10.1016/j.pain.2010.06.012 NIESTERS M, DAHAN A, KEST B, et al .Do sex differences exist in opioid analgesia? A systematic review and meta-analysis of human experimental and clinical studies[J ] .Pain, 2010, 151(1):61-68.DOI:10.1016/j.pain.2010.06.012.

董文芳陆建华术后急性疼痛与慢性疼痛关系的研究进展国际麻醉学与复苏杂志 2015 36 1 78 81 10.3760/cma.j.issn.1673-4378.2015.01.019 董文芳, 陆建华.术后急性疼痛与慢性疼痛关系的研究进展[J].国际麻醉学与复苏杂志, 2015, 36(1):78-81.DOI:10.3760/cma.j.issn.1673-4378.2015.01.019.

DONG W F LU J H The progress of the relationship between acute postoperative pain and chronic postoperative pain Int J Anesth Resus 2015 1 78 81 10.3760/cma.j.issn.1673-4378.2015.01.019 DONG W F, LU J H.The progress of the relationship between acute postoperative pain and chronic postoperative pain[J].Int J Anesth Resus, 2015, (1):78-81.DOI:10.3760/cma.j.issn.1673-4378.2015.01.019.

洪英王泉云刘惠心理因素对术后疼痛的影响中国疼痛医学杂志 2000 3 159 164 10.3969/j.issn.1006-9852.2000.03.010 洪英, 王泉云, 刘惠.心理因素对术后疼痛的影响[J].中国疼痛医学杂志, 2000(3):159-164.DOI:10.3969/j.issn.1006- 9852.2000.03.010.

HONG Y WANG Q Y LIU H The effect of psychological factors on postoperative pain and its clinical significance Chin J Pain Med 2000 3 159 164 10.3969/j.issn.1006-9852.2000.03.010 HONG Y, WANG Q Y, LIU H.The effect of psychological factors on postoperative pain and its clinical significance[J].Chin J Pain Med, 2000(3):159-164.DOI:10.3969/j.issn.1006-9852.2000.03.010.

魏青高鲁渤李锦诚脑电双频指数监测舒芬太尼对患者镇静效应的准确性中华麻醉学杂志 2007 27 5 446 447 10.3760/j.issn:0254-1416.2007.05.019 魏青, 高鲁渤, 李锦诚.脑电双频指数监测舒芬太尼对患者镇静效应的准确性[J].中华麻醉学杂志, 2007, 27(5):446-447.DOI:10.3760/j.issn:0254-1416.2007.05.019.

WEI Q GAO L B LI J C Evaluation of bispectral index for monitoring sedative depth of sufentanfl in patients Chin J Anesth 2007 27 5 446 447 10.3760/j.issn:0254-1416.2007.05.019 WEI Q, GAO L B, LI J C.Evaluation of bispectral index for monitoring sedative depth of sufentanfl in patients[J].Chin J Anesth, 2007, 27(5):446-447.DOI:10.3760/j.issn:0254-1416.2007.05.019.

闫琦冯艺等效镇痛剂量瑞芬太尼、舒芬太尼和芬太尼的镇静效应和不良反应的比较中华麻醉学杂志 2012 32 7 853 856 10.3760/cma.j.issn.0254-1416.2012.07.022 闫琦, 冯艺.等效镇痛剂量瑞芬太尼、舒芬太尼和芬太尼的镇静效应和不良反应的比较[J].中华麻醉学杂志, 2012, 32(7):853-856.DOI:10.3760/cma.j.issn.0254-1416.2012.07.022.

YAN Q FENG Y Differences in sedation level and adverse effects produced by equivalent analgesic doses of remifentanil, sufentanil and fentanyl Chin J Anesth 2012 32 7 853 856 10.3760/cma.j.issn.0254-1416.2012.07.022 YAN Q, FENG Y.Differences in sedation level and adverse effects produced by equivalent analgesic doses of remifentanil, sufentanil and fentanyl[J].Chin J Anesth, 2012, 32(7):853-856.DOI:10.3760/cma.j.issn.0254-1416.2012.07.022.

ALI A ALTUN D OGUZ B H The effect of pre-operative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy J Anesth 2014 28 2 222 227 10.1007/s00540-013-1712-7 ALI A, ALTUN D, OGUZ B H, et al .The effect of pre-operative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy[J ] .J Anesth, 2014, 28(2):222-227.DOI:10.1007/s00540-013-1712-7.

VAUGHN F WICHOWSKI H BOSWORTH G Does preoperative anxiety level predict postoperative pain AORN J 2007 85 3 589 604 10.1016/S0001-2092(07)60130-6 VAUGHN F, WICHOWSKI H, BOSWORTH G.Does preoperative anxiety level predict postoperative pain[J].AORN J, 2007, 85(3):589-604.DOI:10.1016/S0001- 2092(07)60130-6.

GAN T J DIEMUNSCH P HABIB A S Consensus guidelines for the management of postoperative nausea and vomiting Anesth Analg 2014 118 1 85 113 10.1213/ANE.0000000000000002 GAN T J, DIEMUNSCH P, HABIB A S, et al .Consensus guidelines for the management of postoperative nausea and vomiting[J ] .Anesth Analg, 2014, 118(1):85-113.DOI:10.1213/ANE.0000000000000002.

YUE H J GUILLEMINAULT C Opioid medication and sleep-disordered breathing Med Clin North Am 2010 94 3 435 446 10.1016/j.mcna.2010.02.007 YUE H J, GUILLEMINAULT C.Opioid medication and sleep-disordered breathing[J].Med Clin North Am, 2010, 94(3):435-446.DOI:10.1016/j.mcna.2010.02.007.

中华医学会麻醉学分会成人手术后疼痛处理专家共识临床麻醉学杂志 2017 33 9 911 917 http://d.old.wanfangdata.com.cn/Periodical/lcmzxzz201709019 中华医学会麻醉学分会.成人手术后疼痛处理专家共识[J].临床麻醉学杂志, 2017, 33(9):911-917.

Chinese Society of Anesthesiology Expert consensus on post-operative pain management in adults J Clin Anesth 2017 33 9 911 917 http://d.old.wanfangdata.com.cn/Periodical/lcmzxzz201709019 Chinese Society of Anesthesiology.Expert consensus on post-operative pain management in adults[J].J Clin Anesth, 2017, 33(9):911-917.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Ultrasound-guided thoracic paravertebral nerve block in superficial versus deep superior costotransverse ligament: a comparative study of 106 cases

Ultrasound-guided serratus anterior plane block combined with erector spinae plane block for intra- and post-operative analgesia after video-assisted thoracoscopic lobectomy

Effect of patient-controlled intravenous analgesia with dezocine on secretion of prolactin after cesarean section

Continuous femoral nerve block guided by ultrasound united with nerve stimulator for patients after total knee arthroplasty shows better postoperative analgesia and functional rehabilitation effects than patient-controlled intravenous analgesia

Application of ultrasound-guided thoracic paravertebral nerve block combined with PCIA for postoperative analgesia of open partial hepatectomy: a randomized controlled trial

Related Author

Kaizhi LU

Yan CHEN

Rui LYU

Huali ZHU

方亮

李洪

李中奇

蒋力

Related Institution

Department of Anesthesiology, First Affiliated Hospital, Army Medical University (Third Military Medical University)

⁰