Sattari Mohammadreza, Baghdadchi Mohammad Ebrahim, Kheyri Marzieh, Khakzadi Hassan, Ozar Mashayekhi Simin
Infectious and Tropical Research Center, Pharmacology and Toxicology Department, Faculty of Pharmacy, Tabriz University of Medical Sciences, Iran.
Adv Pharm Bull. 2013;3(2):373-7. doi: 10.5681/apb.2013.060. Epub 2013 Aug 20.
To investigate postoperative pain control and analgesic use after heart surgery.
20 patients undergone heart surgery, randomly entered the study. Each patient was asked to score his pain intensity on visual analog scale (VAS) at four different occasions.
120 patients aged 59 year-old; including 81 male were enrolled in the study. 69.2% had coronary artery disease and 16.7% had heart-valve problem. Main types of surgeries were coronary artery bypass surgery (70.5%) and valve repairement (23%). Duration of ICU stay was 4.78±2.7 days and duration of intubations was 17.38 ± 36.46 hours. Pre-surgery pain relief was administrated to 42% of the subjects and morphine and promethazine was the main pre-surgery analgesia medication. Post surgery analgesic included morphine (injection), petidine (injection) and NSAIDS (oral or rectal). According to VAS, mean pain level, 1 and 4 hours after extubation, and before and one hour after transferring to wards was 5.05±2.5, 4.09±2.0, 3.52±1.8, 2.36±1.89, respectively. Although the level of pain reported was mostly moderate, 80% were reported satisfaction with their post-surgery pain management.
A closer pain management control is needed for patients after heart surgery. Introduction of newer pain management techniques, medications and dosages could reduce the pain and suffering.
研究心脏手术后的疼痛控制及镇痛药物使用情况。
20例接受心脏手术的患者随机进入本研究。要求每位患者在四个不同时间点通过视觉模拟评分法(VAS)对其疼痛强度进行评分。
120例患者年龄为59岁,其中男性81例,纳入本研究。69.2%患有冠状动脉疾病,16.7%患有心脏瓣膜问题。主要手术类型为冠状动脉搭桥手术(70.5%)和瓣膜修复术(23%)。重症监护病房(ICU)停留时间为4.78±2.7天,插管时间为17.38±36.46小时。42%的受试者术前接受了镇痛治疗,吗啡和异丙嗪是主要的术前镇痛药物。术后镇痛药包括吗啡(注射)、哌替啶(注射)和非甾体抗炎药(口服或直肠给药)。根据VAS评分,拔管后1小时、4小时、转至病房前及转至病房1小时后的平均疼痛水平分别为5.05±2.5、4.09±2.0、3.52±1.8、2.36±1.89。尽管报告的疼痛程度大多为中度,但80%的患者对术后疼痛管理表示满意。
心脏手术后患者需要更密切的疼痛管理控制。引入更新的疼痛管理技术、药物和剂量可以减轻疼痛和痛苦。