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意大利术后轻中度疼痛管理观察性研究(ITOSPOP)

ITalian Observational Study of the management of mild-to-moderate Post-Operative Pain (ITOSPOP).

机构信息

Department of Anesthesia and Intensive Care, Federico II University, Naples, Italy.

出版信息

Minerva Anestesiol. 2012 Jan;78(1):15-25. Epub 2011 Jun 30.

PMID:21720283
Abstract

BACKGROUND

The multicenter observational ITalian Observational Study on the management of mild-to-moderate PostOperative Pain (ITOSPOP) was carried out in 24 hospitals to describe current postoperative pain management in Italy and the intensity of pain experienced by patients during the first 48 hours after surgery.

METHODS

Adult patients, after surgery expected to result in mild-moderate postoperative pain, underwent six evaluations. The primary endpoint was the level of organization and standardization of postoperative pain management. Secondary objectives included the intensity of postoperative pain, and an assessment of incident pain, postoperative analgesic and concomitant treatment administration.

RESULTS

Only 16.7% hospitals had an acute pain service and 41.7% hospitals applied a standardized protocol for postoperative pain management. The majority (>60%) of the 1952 patients monitored underwent all six assessments, >70% of which were performed by a physician. The proportion of patients with moderate pain decreased during the study period, but almost 10% of patients still experienced moderate pain at study end. Mild pain was reported by 50% of the patients for the entire study duration. At the final assessment, 5% of patients still presented with incident pain frequently interfering with daily activities. Most patients were treated with analgesics, but 20% of patients did not receive any pain medications despite experiencing pain.

CONCLUSION

The level of organization and standardization of postoperative pain management in Italian hospitals remains low. Postoperative analgesic treatment remained suboptimal and almost two-thirds of patients continued to experience pain.

摘要

背景

多中心观察性 ITOSPOP 研究在 24 家医院开展,旨在描述意大利当前的术后轻中度疼痛管理情况,以及患者术后 48 小时内的疼痛强度。

方法

预期术后会产生轻中度疼痛的成年患者接受了 6 次评估。主要终点是术后疼痛管理的组织和标准化程度。次要目标包括术后疼痛强度,以及对疼痛发作、术后镇痛和伴随治疗的评估。

结果

仅有 16.7%的医院设有急性疼痛服务,41.7%的医院采用了标准化的术后疼痛管理方案。1952 名监测患者中,超过 60%的患者完成了所有 6 次评估,其中 70%以上由医生进行。在研究期间,中度疼痛患者的比例有所下降,但仍有近 10%的患者在研究结束时仍有中度疼痛。50%的患者在整个研究期间报告轻度疼痛。在最后一次评估时,5%的患者仍存在经常干扰日常活动的疼痛发作。大多数患者接受了镇痛治疗,但仍有 20%的患者尽管有疼痛仍未接受任何止痛药物。

结论

意大利医院术后疼痛管理的组织和标准化程度仍然较低。术后镇痛治疗仍不理想,近三分之二的患者仍有疼痛。

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