血管外科围手术期疼痛管理分析表明，实际操作未遵循指南：一项回顾性横断面研究。

Analysis of perioperative pain management in vascular surgery indicates that practice does not adhere with guidelines: a retrospective cross-sectional study.

作者信息

Boric Krste, Boric Matija, Boric Teo, Puljak Livia

机构信息

Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia.

Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia; Department of Abdominal Surgery.

出版信息

J Pain Res. 2017 Jan 17;10:203-209. doi: 10.2147/JPR.S123894. eCollection 2017.

DOI:10.2147/JPR.S123894

PMID:28176903

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5261837/

Abstract

BACKGROUND

Inadequate treatment of pain related to surgery may be associated with complications and prolonged recovery time and increased morbidity and mortality rates. We investigated perioperative pain management in vascular surgery and compared it with the relevant guidelines for the treatment of perioperative pain.

METHODS

We conducted a retrospective study on 501 patients who underwent vascular surgery at the University Hospital Split, Croatia. We collected the following data from patients' charts: age, gender, premedication, preoperative patient's physical status, type of surgery, duration of surgery and anesthesia, type of anesthesia, postoperative analgesia, and need for intensive care. We examined departmental procedures to assess adherence to guidelines for perioperative pain management.

RESULTS

None of the 501 patients' charts recorded information about perioperative pain intensity, 28% of patients did not receive any medication the night before their elective surgical procedures, and 17% of patients did not receive premedication immediately before the procedure. Most patients (66%) did not receive any pain medication in the operating room after surgery. Following surgery, 36% of patients were monitored in the intensive care units, while the rest were released to the ward. Some patients (17%) did not receive any analgesia after surgery. Procedures at the department did not adhere to the current recommendations for perioperative pain management.

CONCLUSION

The study indicates that management of surgery-related pain in complex vascular procedures at this hospital did not follow guidelines for the management of acute perioperative pain. Our finding that most patients did not receive appropriate analgesia after vascular surgery leads to the conclusion that the institution would benefit from developing guidelines for the management of acute perioperative pain, which should be applied in all cases.

摘要

背景

手术相关疼痛治疗不充分可能与并发症、恢复时间延长以及发病率和死亡率增加有关。我们调查了血管外科手术围手术期的疼痛管理情况，并将其与围手术期疼痛治疗的相关指南进行了比较。

方法

我们对在克罗地亚斯普利特大学医院接受血管外科手术的501例患者进行了回顾性研究。我们从患者病历中收集了以下数据：年龄、性别、术前用药、术前患者身体状况、手术类型、手术和麻醉持续时间、麻醉类型、术后镇痛以及重症监护需求。我们检查了科室程序以评估对围手术期疼痛管理指南的遵守情况。

结果

501例患者的病历中均未记录围手术期疼痛强度的信息，28%的患者在择期手术前一晚未接受任何药物治疗，17%的患者在手术前未立即接受术前用药。大多数患者（66%）术后在手术室未接受任何止痛药物。术后，36%的患者在重症监护病房接受监测，其余患者被送回病房。一些患者（17%）术后未接受任何镇痛治疗。科室的程序未遵循当前围手术期疼痛管理的建议。