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新的“呼叫算法”管理术后疼痛及其副作用对住院时间的影响：一项两中心前瞻性随机试验。

Influence of a New "Call-Out Algorithm" for Management of Postoperative Pain and Its Side Effects on Length of Stay in Hospital: A Two-Centre Prospective Randomized Trial.

机构信息

Department of Anaesthesia and Intensive Care, Akershus University Hospital, 1478 Lørenskog, Norway.

Department of Anaesthesia and Intensive Care Medicine, Kongsberg Hospital, 3612 Kongsberg, Norway.

出版信息

Pain Res Manag. 2017;2017:9431984. doi: 10.1155/2017/9431984. Epub 2017 Aug 10.

DOI:10.1155/2017/9431984
PMID:28855800
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5569639/
Abstract

BACKGROUND

We recently introduced the efficacy safety score (ESS) a new "call-out algorithm" for management of postoperative pain and side effects. In this study, we report the influence of ESS recorded hourly during the first 8 hours after surgery on the mobility degree, postoperative nonsurgical complications, and length of hospital stay (LOS).

METHODS

We randomized 1152 surgical patients into three groups for postoperative observation: (1) ESS group ( = 409), (2) Verbal Numeric Rate Scale (VNRS) for pain group ( = 417), and (3) an ordinary qualitative observation (Control) group ( = 326). An ESS > 10 or VNRS > 4 at rest or a nurse's observation of pain or adverse reaction to analgesic treatment in the Control group served as a "call-out alarm" for an anaesthesiologist.

RESULTS

We found no significant differences in the mobility degree and number of postoperative nonsurgical complications between the groups. LOS was significantly shorter with 12.7 ± 6.3 days (mean ± SD) in the ESS group versus 14.2 ± 6.2 days in the Control group ( < 0.001).

CONCLUSION

Postoperative ESS recording in combination with the possibility to call upon an anaesthesiologist when exceeding the threshold score might have contributed to the reductions of LOS in this two-centre study. This trial is registered with NCT02143128.

摘要

背景

我们最近引入了疗效安全评分（ESS），这是一种新的“报警算法”，用于管理术后疼痛和副作用。在这项研究中，我们报告了在手术后的头 8 小时内每小时记录的 ESS 对活动度、术后非手术并发症和住院时间（LOS）的影响。

方法

我们将 1152 名手术患者随机分为三组进行术后观察：（1）ESS 组（n = 409），（2）疼痛的口述数字评分法（VNRS）组（n = 417），和（3）普通定性观察（对照组）组（n = 326）。ESS > 10 或 VNRS > 4 时的静息疼痛或护士观察到的疼痛或对镇痛治疗的不良反应，以及对照组中的任何一种情况，均作为麻醉师的“报警信号”。

结果

我们发现三组之间的活动度和术后非手术并发症的数量没有显著差异。ESS 组的 LOS 显著缩短，为 12.7 ± 6.3 天（均值 ± 标准差），而对照组为 14.2 ± 6.2 天（< 0.001）。

结论

术后 ESS 记录结合超过阈值评分时呼叫麻醉师的可能性，可能有助于减少这项双中心研究的 LOS。这项试验在 NCT02143128 注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/441b68c2effb/PRM2017-9431984.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/6b9e7fa6ce16/PRM2017-9431984.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/b70e7a5e9830/PRM2017-9431984.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/ec94002d533a/PRM2017-9431984.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/995a4d05ca07/PRM2017-9431984.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/441b68c2effb/PRM2017-9431984.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/6b9e7fa6ce16/PRM2017-9431984.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/b70e7a5e9830/PRM2017-9431984.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/ec94002d533a/PRM2017-9431984.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/995a4d05ca07/PRM2017-9431984.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86fc/5569639/441b68c2effb/PRM2017-9431984.005.jpg

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