Balanyuk Ihor, Ledonne Giuseppina, Provenzano Marco, Bianco Roberto, Meroni Cristina, Ferri Paola, Bonetti Loris
Intensive Care Unit, IRCCS Humanitas, Rozzano, Milan, Italy..
Department of nursing, Degree Course in Nursing, University of Milan, ASST Fatebenefratelli Sacco, Luigi Sacco Teaching Hospital, Milan, Italy..
Acta Biomed. 2018 Feb 21;89(4-S):55-63. doi: 10.23750/abm.v89i4-S.7115.
Procedural pain during Peripheral Venous Catheterization (PVC) is a significant issue for patients. Reducing procedure-induced pain improves the quality of care and reduces patient discomfort. We aimed to compare a non-pharmacological technique (distraction) to anaesthetic cream (EMLA) for the reduction of procedural pain during PVC, in patients undergoing Computerized Tomography (CT) or Nuclear Magnetic Resonance (NMR) with contrast.
This is a Prospective, Randomized Controlled Trial. The study was carried out during the month of October 2015. A total of 72 patients undergoing PVC were randomly assigned to the experimental group (distraction technique, n=36) or control group (EMLA, n=36). After PVC, pain was evaluated by means of the numeric pain-rating scale (NRS). Pain perception was compared by means of Mann-Whitney Test.
The average pain in the distraction group was 0.69 (SD±1.26), with a median value of 0. The average pain in the EMLA group was 1.86 (SD±1.73), with a median value of 2. The study showed a significant improvement from the distraction technique (U=347, p<.001, r=.42) with respect to the local anaesthetic in reducing pain perception. Conclusions/Implication for practice: Distraction is more effective than local anaesthetic in reducing of pain-perception during PVC insertion. This study is one of few comparing the distraction technique to an anaesthetic. It confirms that the practitioner-patient relationship is an important point in nursing assistance, allowing the establishment of trust with the patient and increasing compliance during the treatment process.
外周静脉置管(PVC)过程中的程序性疼痛对患者而言是一个重大问题。减轻操作引起的疼痛可提高护理质量并减少患者不适。我们旨在比较一种非药物技术(分散注意力)与麻醉乳膏(复方利多卡因乳膏)在接受计算机断层扫描(CT)或磁共振成像(NMR)增强检查的患者进行PVC时减轻程序性疼痛的效果。
这是一项前瞻性随机对照试验。研究于2015年10月进行。共有72例接受PVC的患者被随机分为实验组(分散注意力技术,n = 36)或对照组(复方利多卡因乳膏,n = 36)。PVC操作后,通过数字疼痛评分量表(NRS)评估疼痛。采用曼-惠特尼检验比较疼痛感知情况。
分散注意力组的平均疼痛评分为0.69(标准差±1.26),中位数为0。复方利多卡因乳膏组的平均疼痛评分为1.86(标准差±1.73),中位数为2。研究表明,在减轻疼痛感知方面,分散注意力技术(U = 347,p <.001,r =.42)相对于局部麻醉剂有显著改善。结论/对实践的启示:在PVC置管过程中,分散注意力在减轻疼痛感知方面比局部麻醉更有效。本研究是比较分散注意力技术与麻醉剂的少数研究之一。它证实了医患关系是护理工作中的一个重要方面,有助于与患者建立信任并提高治疗过程中的依从性。