Jensen Louise, Rebeyka Darlene, Urquhart Gayle, Roschkov Sylvia
Faculty of Nursing, University of Alberta, Edmonton, Alberta, T6G 2G3.
Can J Cardiovasc Nurs. 2004;14(1):8-17.
The purpose of this study was to describe pain in adults post surgical repair for congenital heart defects. What is the intensity, sensory, and affective dimensions of pain experienced post-operatively? What is the trend in pain experienced post-operatively over time? What is the effectiveness of post-operative pain management strategies? What factors influence the dimensions of post-operative pain experienced? A descriptive prospective repeated measures design was used with 30 adult congenital heart (ACH) post-operative patients. Pain assessments using the McGill Short Form Questionnaire (MSFQ), a visual analogue pain scale (VAP), and recordings of other variables (analgesic, anxiety, activity level, non-pharmacologic intervention) were performed three times daily until hospital discharge. Mean pain intensity scores ranged from 2.44 +/- 1.31 following extubation to 1.30 +/- 0.66 on post-operative day (POD) five (scale, 0-5). Mean MSFQ scores ranged from 9.26 +/- 7.21 following extubation to 4.40 +/- 5.22 on POD five (scale, 0-45). Mean VAP scores ranged from 50.77 +/- 25.79 following extubation to 18.76 +/- 18.50 on POD five (scale, 0-100). Mean number of narcotic doses per day ranged from 4.61 +/- 2.01 to 1.88 +/- 1.98 on PODs one and five, respectively. Anxiety predicted VAP and MSFQ scores on PODs one and two; anxiety and analgesia doses predicted VAP and MSFQ scores on POD three; analgesia doses predicted MSFQ scores, analgesia and anxiety predicted VAP scores on POD four; analgesia doses and anxiety predicted VAP and MSFQ scores on POD five. No relationships were found among pain and other demographic, treatment, or clinical variables. Overall, pain was reported as mild to moderate intensity, variable in sensations, decreased over time, and adequately managed.
本研究的目的是描述先天性心脏病手术后成人的疼痛情况。术后经历的疼痛在强度、感觉和情感方面如何？术后疼痛随时间的变化趋势是怎样的？术后疼痛管理策略的效果如何？哪些因素会影响术后疼痛的各个方面？本研究采用描述性前瞻性重复测量设计，对30例成年先天性心脏病（ACH）术后患者进行了研究。使用麦吉尔简短问卷（MSFQ）、视觉模拟疼痛量表（VAP）进行疼痛评估，并每天三次记录其他变量（镇痛药、焦虑、活动水平、非药物干预），直至出院。平均疼痛强度评分从拔管后的2.44±1.31到术后第5天（POD）的1.30±0.66（范围为0 - 5）。平均MSFQ评分从拔管后的9.26±7.21到术后第5天的4.40±5.22（范围为0 - 45）。平均VAP评分从拔管后的50.77±25.79到术后第5天的18.76±18.50（范围为0 - 100）。每天的平均麻醉药剂量在术后第1天和第5天分别为4.61±2.01和1.88±1.98。焦虑在术后第1天和第2天预测VAP和MSFQ评分；焦虑和镇痛药剂量在术后第3天预测VAP和MSFQ评分；镇痛药剂量在术后第4天预测MSFQ评分，镇痛药和焦虑在术后第4天预测VAP评分；镇痛药剂量和焦虑在术后第5天预测VAP和MSFQ评分。未发现疼痛与其他人口统计学、治疗或临床变量之间存在关联。总体而言，报告的疼痛强度为轻度至中度，感觉各异，随时间减轻，且得到了充分管理。
