Jaksch W, Likar R, Frohner U, Herbst F
Abteilung für Anästhesie, Intensiv- und Schmerzmedizin, Wilhelminenspital, Montleartstraße 37, 1160, Wien, Österreich.
Klinikum Klagenfurt am Wörtersee, Klagenfurt am Wörtersee, Österreich.
Schmerz. 2018 Jun;32(3):171-180. doi: 10.1007/s00482-018-0291-9.
Pain after surgery, especially on the first postoperative day, results in longer hospital stays, increased complication rates and may also cause a higher risk of pain chronification. However, the expected intensity of pain is often misjudged and therefore not adequately treated.
An Austria-wide patient survey on the pain situation on the first postoperative day and on the quality of perioperative pain management was carried out on a voluntary and anonymous basis.
Regarding the intensity of pain a clear gender difference could be observed. Women were more prone to more severe pain than men across all age groups. This difference was most pronounced in the younger age groups (18-40 years) and in those patients showing the highest pain scores. Treatment satisfaction was correlated (high significance) with pain intensity on exercise (p < 0.01), maximum pain (p < 0.01), least pain (<0.01) and frequency of postoperative pain assessment.
The risk of postoperative pain can be reduced by optimal care structures. Since patients treated in optimal care structures had significantly lower pain scores on exercise and with respect to maximum pain, the investment in the optimization of such resources should be carefully planned. Special attention should be paid to postoperative pain management in women, especially in younger female patients.
术后疼痛,尤其是在术后第一天,会导致住院时间延长、并发症发生率增加,还可能导致疼痛慢性化的风险更高。然而,人们常常误判预期的疼痛强度,因此未能得到充分治疗。
在奥地利范围内开展了一项关于术后第一天疼痛情况及围手术期疼痛管理质量的患者调查,该调查是自愿且匿名的。
在疼痛强度方面,可以观察到明显的性别差异。在所有年龄组中,女性比男性更容易出现更严重的疼痛。这种差异在较年轻的年龄组(18 - 40岁)和疼痛评分最高的患者中最为明显。治疗满意度与运动时的疼痛强度(p < 0.01)、最大疼痛(p < 0.01)、最小疼痛(<0.01)以及术后疼痛评估频率呈显著相关。
通过优化护理结构可以降低术后疼痛的风险。由于在优化护理结构中接受治疗的患者在运动时和最大疼痛方面的疼痛评分显著更低,因此应仔细规划对优化此类资源的投入。应特别关注女性患者的术后疼痛管理,尤其是年轻女性患者。