Kjeldsen Helle Birgitte, Klausen Tobias Wirenfeldt, Rosenberg Jacob
Department of Surgery, Herlev Hospital, Herlev, Denmark.
Department of Hematology, Herlev Hospital, Herlev, Denmark.
Pain Pract. 2016 Nov;16(8):980-984. doi: 10.1111/papr.12344. Epub 2015 Aug 27.
The aim of this study was to evaluate differences in pain scores with different visual analog scale (VAS) presentations and to compare those differences with a numeric rating scale. We also asked the patients for preference of the different methods.
Prior to the trial, we performed power calculations to estimate a preferred sample size, and 62 postoperative patients supplied a complete set of data to the study. Inclusion criteria were newly operated patients within the first 5 days after surgery. Every patient included was with 1-minute intervals and presented with one of the following 100-mm VAS lines: VAS horizontal with or without stop lines at the endings, or VAS vertical with or without stop lines. They also completed a numeric rating scale (NRS).
We did not find differences in pain scores between the four VAS measures. The NRS had slightly higher pain scores than VAS, especially at low levels of pain. Patients preferred the NRS as compared to the VAS, and when choosing between the four different VAS presentations, they preferred the horizontal VAS with stop lines at the ends.
For daily clinical practice for guiding postoperative analgesic treatment, the NRS seems to be a good option measuring pain reliably with good patient understanding and acceptance. For pain research, where there may be more time to explain the method and when a scale with more data points may be preferred, a VAS horizontal including stop lines at the ends can be recommended.
本研究旨在评估不同视觉模拟量表(VAS)呈现方式下疼痛评分的差异,并将这些差异与数字评分量表进行比较。我们还询问了患者对不同方法的偏好。
在试验前,我们进行了功效计算以估计最佳样本量,62例术后患者为该研究提供了完整的数据集。纳入标准为术后前5天内的新手术患者。纳入的每位患者每隔1分钟接受以下100毫米VAS线中的一种呈现:带或不带末端终止线的水平VAS,或带或不带终止线的垂直VAS。他们还完成了数字评分量表(NRS)。
我们未发现四种VAS测量方法之间的疼痛评分存在差异。NRS的疼痛评分略高于VAS,尤其是在低疼痛水平时。与VAS相比,患者更喜欢NRS,并且在四种不同的VAS呈现方式中进行选择时,他们更喜欢末端带有终止线的水平VAS。
对于指导术后镇痛治疗的日常临床实践,NRS似乎是一个很好的选择,它能可靠地测量疼痛,且患者易于理解和接受。对于疼痛研究,在可能有更多时间解释方法且可能更倾向于使用具有更多数据点的量表时,可推荐使用末端带有终止线的水平VAS。