Ahmed Aliya, Yasir Muhammad
Department of Anaesthesiology, Aga Khan University, Karachi.
J Pak Med Assoc. 2015 Nov;65(11):1164-8.
To assess the frequency and types of adjustments that acute pain service makes to postoperative analgesic regimes to improve pain relief or treat side effects.
The prospective observational study was conducted at the Aga Khan University Hospital, Karachi, from December 1, 2012, to March 31, 2013. Data was collected from Acute Pain Service register four hours after the pain rounds by a Service member not involved in rounds. Data was collected on a standardised form and analysed using SPSS 19.
Of the 323 patients, 209(65%) were receiving epidural infusions and 114(35%) were receiving intravenous patient-controlled analgesia. Overall, 114(35%) required action by Acute Pain Service; 76(66.6%) with epidural infusions and 38(33.3%) intravenous analgesia. Besides, 98(85.9%) had inadequate pain relief, 61(62%) with epidural and 37(38%) with analgesia. Post-intervention, motor block occurred in 13(11.4%) patients, who were managed by change of patient's position and/or lowering the concentration of epidural solution. Improvement was seen in all patients after the adjustments.
Acute Pain Service played an important role in improving the quality of postoperative pain relief and management of analgesia-related side effects. Regular feedback to the primary anaesthesiologist can lead to improved practices.
评估急性疼痛服务部门对术后镇痛方案进行调整的频率和类型，以改善疼痛缓解情况或治疗副作用。
这项前瞻性观察性研究于2012年12月1日至2013年3月31日在卡拉奇的阿迦汗大学医院进行。数据由未参与查房的服务人员在疼痛查房后4小时从急性疼痛服务登记册中收集。数据采用标准化表格收集，并使用SPSS 19进行分析。
在323例患者中，209例（65%）接受硬膜外输注，114例（35%）接受静脉自控镇痛。总体而言，114例（35%）患者需要急性疼痛服务部门采取行动；硬膜外输注患者中有76例（66.6%），静脉镇痛患者中有38例（33.3%）。此外，98例（85.9%）患者疼痛缓解不足，硬膜外镇痛患者中有61例（62%），静脉镇痛患者中有37例（38%）。干预后，13例（11.4%）患者出现运动阻滞，通过改变患者体位和/或降低硬膜外溶液浓度进行处理。调整后所有患者均有改善。
急性疼痛服务部门在提高术后疼痛缓解质量和管理镇痛相关副作用方面发挥了重要作用。定期向主麻醉医生反馈可改善操作方法。
