Piotrowski Marcia M, Paterson Cynthia, Mitchinson Allison, Kim Hyungjin Myra, Kirsh Marvin, Hinshaw Daniel B
Performance Improvement Department, VA Ann Arbor Health Care System, MI 48105, USA.
J Am Coll Surg. 2003 Dec;197(6):1037-46. doi: 10.1016/j.jamcollsurg.2003.07.020.
Opioid analgesia alone may not fully relieve all aspects of acute postoperative pain. Complementary medicine techniques used as adjuvant therapies have the potential to improve pain management and palliate postoperative distress.
This prospective randomized clinical trial compared pain relief after major operations in 202 patients who received one of three nursing interventions: massage, focused attention, or routine care. Interventions were performed twice daily starting 24 hours after the operation through postoperative day 7. Perceived pain was measured each morning.
The rate of decline in the unpleasantness of postoperative pain was accelerated by massage (p = 0.05). Massage also accelerated the rate of decline in the intensity of postoperative pain but this effect was not statistically significant. Use of opioid analgesics was not altered significantly by the interventions.
Massage may be a useful adjuvant therapy for the management of acute postoperative pain. Its greatest effect appears to be on the affective component (ie, unpleasantness) of the pain.
单纯使用阿片类镇痛药可能无法完全缓解术后急性疼痛的所有方面。作为辅助疗法的补充医学技术有改善疼痛管理和减轻术后痛苦的潜力。
这项前瞻性随机临床试验比较了202例接受三种护理干预之一(按摩、集中注意力或常规护理)的大手术患者术后的疼痛缓解情况。干预措施在术后24小时开始,每天进行两次,持续至术后第7天。每天早晨测量患者的疼痛感受。
按摩加速了术后疼痛不适感的下降速度(p = 0.05)。按摩还加快了术后疼痛强度的下降速度,但这种效果无统计学意义。干预措施对阿片类镇痛药的使用没有显著影响。
按摩可能是一种用于管理术后急性疼痛的有用辅助疗法。其最大效果似乎体现在疼痛的情感成分(即不适感)上。