McGrath Diane, Thurston Norma, Wright Dale, Preshaw Roy, Fermin Punch
Departments of Nursing, Pharmacy and Surgery, Foothills Hospital and University of Calgary, Calgary, AlbertaCanada.
Pain. 1989 Jun;37(3):265-270. doi: 10.1016/0304-3959(89)90190-5.
We have compared analgesic requirements, perceived pain, and self-assessment of 'health locus of control' for 72 h in 88 subjects after cholecystectomy, randomized to either a standard technique of self-administration of meperidine (patient-controlled analgesia, PCA) or to intramuscular injections on demand (i.m.). Multivariate analysis revealed no statistical differences between group scores for pain (over any 24 h period) and only minor differences in total meperidine administered. However, the PCA group received significantly less analgesic in the first 24 h (P less than 0.01) and described significantly more pain over the first 4 h (P less than 0.01). Assessment of 'health locus of control' did not show any marked changes. Analysis of patient questionnaires suggests more enthusiasm for patient-controlled analgesia, but in this study, it was difficult to clearly demonstrate any significant advantage for pain management or amount of opiate administered.
我们比较了88例胆囊切除术后患者在72小时内的镇痛需求、疼痛感受以及“健康控制点”的自我评估情况。这些患者被随机分为两组，一组采用标准的哌替啶自我给药技术（患者自控镇痛，PCA），另一组按需肌内注射（i.m.）。多变量分析显示，两组在疼痛评分（任何24小时时间段内）上无统计学差异，且在哌替啶总给药量上仅有微小差异。然而，PCA组在最初24小时内接受的镇痛药物明显较少（P<0.01），且在最初4小时内描述的疼痛明显更多（P<0.01）。“健康控制点”的评估未显示出任何明显变化。对患者问卷的分析表明，患者对患者自控镇痛更有热情，但在本研究中，很难明确证明其在疼痛管理或阿片类药物给药量方面有任何显著优势。
