Kokinsky E, Thornberg E, Ostlund A L, Larsson L E
Department of Paediatric Anaesthesia and Intensive Care, Sahlgrenska Universitetssjukhuset, Ostra, Göteborg, Sweden.
Paediatr Anaesth. 1999;9(3):243-51.
Postoperative conditions in hospital and at home were evaluated in 200 paediatric daycase patients by using questionnaires and telephone interviews. Pain was assessed by behaviour observation or a faces rating scale depending on age. Anaesthetic methods, nausea/vomiting, analgesics and parents' aspects were also recorded. Seventy per cent of the patients received regional anaesthesia. Immediate postoperative analgesia was satisfactory in 75% of the children. When the effects of intraoperatively administered analgesics wore off at home almost half the children rated higher than mild pain. The increased degree of pain at home was especially pronounced after regional anaesthesia. The total incidence of nausea/vomiting was 28% and fentanyl caused nausea and vomiting in a significantly higher proportion of cases. The study points out that immediate postoperative comfort obtained by prophylactic analgesia needs to be followed by analgesics given on a continuous basis for the first days after surgery.
通过问卷调查和电话访谈对200例儿科日间手术患者的术后住院及居家情况进行了评估。根据年龄,通过行为观察或面部表情评分量表评估疼痛程度。同时记录麻醉方法、恶心/呕吐情况、镇痛药物使用情况以及家长的看法。70%的患者接受了区域麻醉。75%的儿童术后即刻镇痛效果令人满意。当术中使用的镇痛药在家中失效后,近一半的儿童疼痛程度高于轻度疼痛。在家中疼痛程度增加在区域麻醉后尤为明显。恶心/呕吐的总发生率为28%,芬太尼导致恶心和呕吐的比例显著更高。该研究指出,术后即刻通过预防性镇痛获得的舒适感,术后头几天需要持续给予镇痛药。