Jungquist Carla R, Smith Kirsten, Nicely Kelly L Wiltse, Polomano Rosemary C
Carla R. Jungquist is an assistant professor in the University at Buffalo School of Nursing, Buffalo, NY. Kirsten Smith is a clinical nurse specialist at Penn Presbyterian Medical Center, University of Pennsylvania, Philadelphia. Kelly L. Wiltse Nicely is an assistant professor of nurse anesthesia in the Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia. Rosemary C. Polomano is a professor of pain practice at the University of Pennsylvania School of Nursing. Contact author: Carla R. Jungquist,
Am J Nurs. 2017 Mar;117(3 Suppl 1):S27-S35. doi: 10.1097/01.NAJ.0000513528.79557.33.
: Opioid analgesics are commonly administered to hospitalized patients to treat acute pain, but these drugs put patients at risk for serious adverse events, such as unintended advancing sedation, respiratory depression, and death. Nurses play an important role in keeping patients safe by making clinical decisions about the frequency and intensity with which patients receiving IV and epidural opioids should be monitored. To make sound clinical judgments, nurses must be aware of the factors that place patients at elevated risk for adverse opioid-related effects and know how to screen and assess patients for these risks. The authors review the literature on unintended advancing sedation and respiratory depression associated with opioid administration and present evidence-based recommendations for clinical decision making and patient monitoring, using both nursing assessments and electronic technologies.
阿片类镇痛药常用于住院患者以治疗急性疼痛,但这些药物会使患者面临严重不良事件的风险,如意外的深度镇静、呼吸抑制和死亡。护士在保障患者安全方面发挥着重要作用,他们要对接受静脉注射和硬膜外阿片类药物的患者的监测频率和强度做出临床决策。为了做出合理的临床判断,护士必须了解使患者发生阿片类药物相关不良影响风险升高的因素,并知道如何对患者进行这些风险的筛查和评估。作者回顾了与阿片类药物使用相关的意外深度镇静和呼吸抑制的文献,并提出基于证据的临床决策和患者监测建议,同时运用护理评估和电子技术。