多联数字评分量表在开胸术后患者自控静脉镇痛方案中的应用

秦雪; 刘娟; 鲁开智; 王莉

doi:10.16016/j.1000-5404.201802055

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多联数字评分量表在开胸术后患者自控静脉镇痛方案中的应用

临床医学 | 更新时间：2026-01-09

- 多联数字评分量表在开胸术后患者自控静脉镇痛方案中的应用
- Application of multi-scale digital scoring scale in patient-controlled intravenous analgesia after thoracotomy
- 第三军医大学学报 2018年40卷第16期页码：1518-1522
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201802055
  中图分类号：
- 收稿：2018-02-07，
  
  纸质出版：2018-08-30
- 稿件说明：
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秦雪, 刘娟, 鲁开智, 等. 多联数字评分量表在开胸术后患者自控静脉镇痛方案中的应用[J]. 第三军医大学学报, 2018,40(16):1518-1522.

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.
秦雪, 刘娟, 鲁开智, 等. 多联数字评分量表在开胸术后患者自控静脉镇痛方案中的应用[J]. 第三军医大学学报, 2018,40(16):1518-1522. DOI： 10.16016/j.1000-5404.201802055.

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

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