Wheatley R G, Madej T H, Jackson I J, Hunter D
Department of Anaesthesia, York District Hospital.
Br J Anaesth. 1991 Sep;67(3):353-9. doi: 10.1093/bja/67.3.353.
The benefits, risks and resource implications of providing an Acute Pain Service were assessed during the first year of the service. Six hundred and sixty patients recovering from major surgery were treated with patient-controlled analgesia (510 patients) or extradural infusion analgesia (150 patients). The results of a prospective outcome study showed that pain control was good: more than 60% of patients scored their pain as mild during the first 24 h. Only 10% of patients complained of severe postoperative pain. Eight patients developed potentially serious complications including respiratory depression and hypotension; the diagnosis and management of these problems on general wards is discussed. Retrospective analysis of the incidence of postoperative chest infection in surgical patients showed a marked reduction during the first year of the service (1.3% in 1988, 0.4% in 1989-90 (P less than 0.01].
在急性疼痛服务开展的第一年，对提供该服务的益处、风险及资源影响进行了评估。660例接受大手术康复的患者接受了患者自控镇痛（510例患者）或硬膜外输注镇痛（150例患者）治疗。一项前瞻性结局研究结果显示，疼痛控制良好：超过60%的患者在最初24小时内将疼痛评为轻度。只有10%的患者抱怨术后疼痛严重。8例患者出现了包括呼吸抑制和低血压在内的潜在严重并发症；讨论了在普通病房对这些问题的诊断和处理。对手术患者术后胸部感染发生率的回顾性分析显示，在服务开展的第一年有显著下降（1988年为1.3%，1989 - 1990年为0.4%，P < 0.01）。
