Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Universitätsklinikum Essen, Essen, Germany.
Br J Anaesth. 2010 Oct;105(4):511-8. doi: 10.1093/bja/aeq186. Epub 2010 Aug 6.
The goal of this study was to develop and validate the overall benefit of analgesic score (OBAS), which assesses pain intensity and the opioid-related adverse effects.
The score was developed and validated in four trials (n=1470 patients). Data from randomized trial I were used to develop the OBAS (factor analysis). Data from randomized trial II were used to compare the resolution of rofecoxib's analgesic effects between OBAS and pain scores. Randomized trial III (spine surgery) was conducted to evaluate prospectively the reliability of the OBAS and to compare its resolution of analgesic treatment with the opioid-related symptom distress scale (OR-SDS) and the modified brief pain inventory short form (m-BPI-sf). Trial IV was conducted to evaluate in patients with a moderate-to-high level of postoperative pain (after major abdominal surgery) the relation of OBAS and pain scores for patients' satisfaction with analgesic therapy.
The seven-item OBAS yielded a higher resolution of analgesic treatment effects than pain scores, the OR-SDS and m-BPI-sf. The OBAS has a fair inter-rater reliability (concordance correlation of 0.71 c) and is more sensitive (P=0.03) in indicating the delivery of opioid boluses than the dedicated OR-SDS. The OBAS, but not pain scores at rest or pain scores during movement, explained significant variance in patients' satisfaction with postoperative pain therapy.
The OBAS is a simple, multi-dimensional quality assessment instrument to measure patients' benefit from postoperative pain therapy. Opioid symptom distress, pain relief, and patients' satisfaction are combined in a reliable and valid tool.
本研究旨在开发和验证总体获益镇痛评分（OBAS），该评分用于评估疼痛强度和阿片类药物相关不良反应。
该评分在四项试验（n=1470 例患者）中开发和验证。来自随机试验 I 的数据用于开发 OBAS（因子分析）。来自随机试验 II 的数据用于比较 OBAS 与疼痛评分对罗非昔布镇痛效果的缓解情况。前瞻性随机试验 III（脊柱手术）用于评估 OBAS 的可靠性，并比较其与阿片类药物相关症状困扰量表（OR-SDS）和改良简短疼痛量表简表（m-BPI-sf）在评估镇痛治疗效果方面的差异。随机试验 IV 用于评估中度至高度术后疼痛（大型腹部手术后）患者的 OBAS 与疼痛评分与患者对镇痛治疗满意度的关系。
七项 OBAS 评分比疼痛评分、OR-SDS 和 m-BPI-sf 更能准确地反映镇痛治疗效果。OBAS 具有较好的组内一致性（一致性相关系数为 0.71 c），且比专用的 OR-SDS 更能灵敏地（P=0.03）提示阿片类药物冲击剂量的应用。OBAS 评分，而非静息或运动时的疼痛评分，能更好地解释患者对术后疼痛治疗满意度的差异。
OBAS 是一种简单的多维质量评估工具，可用于衡量患者术后疼痛治疗的获益。阿片类药物相关症状困扰、疼痛缓解和患者满意度被整合在一个可靠且有效的工具中。
