Department of Nursing, Sunchon National University, Suncheon, Korea.
Korean J Pain. 2013 Jul;26(3):277-85. doi: 10.3344/kjp.2013.26.3.277. Epub 2013 Jul 1.
Opioid analgesics are widely used to reduce postoperative pain and to enhance post-operative recovery. However, orthostatic intolerance (OI) induced by opioid containing intravenous patient controlled analgesia (IPCA) may hinder postoperative recovery. This study investigated factors that affect OI in patients receiving IPCA for postoperative pain control.
OI was instantly evaluated at the time of first ambulation in 175 patients taking opioid containing IPCA after open and laparoscopic subtotal gastrectomies. Patients were classified as having OI if they experienced dizziness, nausea/vomiting, blurred vision, headache, somnolence and syncope. Factors contributing to OI were assessed with logistic regression analysis.
Out of 175 patients, 61 (52.6%) male and 44 (74.6%) female patients experienced OI at the time of first ambulation. The frequency of OI related symptoms were dizziness (97, 55.4%), nausea (46, 26.3%), headache (9, 5.1%), blurred vision (3, 1.7%) and vomiting (2, 1.1%). Significant risk factors for OI were gender (P=0.002) and total amount of opioids administered (P=0.033).
The incidence of OI is significantly higher in male than in female patients and is influenced by the opioid dose.
阿片类镇痛药被广泛用于减轻术后疼痛并促进术后恢复。然而，含阿片类药物的静脉患者自控镇痛（IPCA）引起的直立不耐受（OI）可能会妨碍术后恢复。本研究调查了接受 IPCA 控制术后疼痛的患者中影响 OI 的因素。
在 175 例接受开腹和腹腔镜胃大部切除术的患者中，在首次下床活动时即刻评估 OI。如果患者出现头晕、恶心/呕吐、视力模糊、头痛、嗜睡和晕厥，则将其归类为 OI。使用逻辑回归分析评估导致 OI 的因素。
在 175 例患者中，61 例（52.6%）为男性，44 例（74.6%）为女性患者在首次下床活动时出现 OI。OI 相关症状的发生频率为头晕（97 例，55.4%）、恶心（46 例，26.3%）、头痛（9 例，5.1%）、视力模糊（3 例，1.7%）和呕吐（2 例，1.1%）。OI 的显著危险因素是性别（P=0.002）和给予的阿片类药物总量（P=0.033）。
男性患者的 OI 发生率明显高于女性患者，并且受阿片类药物剂量的影响。
