视觉模拟量表上疼痛的临床显著变化。

Clinically significant changes in pain along the visual analog scale.

作者信息

Bird S B, Dickson E W

机构信息

Departments of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.

出版信息

Ann Emerg Med. 2001 Dec;38(6):639-43. doi: 10.1067/mem.2001.118012.

DOI:10.1067/mem.2001.118012

PMID:11719742

Abstract

STUDY OBJECTIVE

We sought to test the hypothesis that the change in visual analog scale (VAS) associated with a clinically significant change in pain is related to the initial VAS score.

METHODS

A convenience sample of adults with isolated extremity trauma was enrolled. A VAS score was obtained on entry into the study. Descriptions of change in pain ("lot less," "little less," "about the same," "little more," or "lot more") and VAS scores were then obtained every 30 minutes until the patient was free of pain or discharged or a total of 2 hours had passed. Patients were divided into 3 cohorts on the basis of the initial VAS score: VAS score of less than 34, VAS score of 34 to 66, and VAS score of 67 or greater. The absolute values of VAS changes associated with pain descriptions of a "little less" or "little more" (defined as clinically significant), "about the same" (defined as clinically insignificant), and "lot less" or "lot more" were calculated.

RESULTS

The change in VAS associated with clinically significant changes in pain in the cohort with VAS scores of less than 34 was 13+/-14 (mean+/-SD), which was significantly lower than that of the cohort with VAS scores of 67 or greater (28+/-21). There was no statistically significant difference in clinically significant changes in pain between the middle cohort and either the upper or lower cohorts (P =.07 and P =.29, respectively). There was no significant change in VAS for clinically insignificant changes in pain among the 3 cohorts (3+/-4, 6+/-6, and 8+/-16, respectively).

CONCLUSION

Patients with greater pain require a greater change in VAS score to achieve clinically significant pain relief.

摘要

研究目的

我们试图验证这一假设，即与临床上显著的疼痛变化相关的视觉模拟评分（VAS）变化与初始VAS评分有关。

方法

纳入了一个方便样本，为患有孤立性肢体创伤的成年人。在进入研究时获取VAS评分。然后每30分钟获取一次疼痛变化描述（“好多了”“稍好一些”“差不多”“稍差一些”或“差得多”）及VAS评分，直到患者无痛或出院，或者总共经过2小时。根据初始VAS评分将患者分为3组：VAS评分低于34、VAS评分34至66以及VAS评分67或更高。计算与“稍好一些”或“稍差一些”（定义为临床上显著）、“差不多”（定义为临床上不显著）以及“好多了”或“差得多”的疼痛描述相关的VAS变化绝对值。

结果

VAS评分低于34的组中，与临床上显著的疼痛变化相关的VAS变化为13±14（均值±标准差），显著低于VAS评分67或更高组（28±21）。中间组与上组或下组在临床上显著的疼痛变化方面无统计学显著差异（分别为P = 0.07和P = 0.29）。3组中与临床上不显著的疼痛变化相关的VAS无显著变化（分别为3±4、6±6和8±16）。