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灌注指数能否用作分娩镇痛中疼痛评估的客观工具?

Can Perfusion Index be used as an Objective Tool for Pain Assessment in Labor Analgesia?

作者信息

Kupeli Ilke, Kulhan Nur Gozde

机构信息

Dr. Ilke Kupeli, Department of Anesthesiology and Reanimation, Erzincan University, Erzincan, Turkey.

Nur Gozde Kulhan, Department of Gynecology and Obstetrics, Erzincan University, Erzincan, Turkey.

出版信息

Pak J Med Sci. 2018 Sep-Oct;34(5):1262-1266. doi: 10.12669/pjms.345.15157.

Abstract

OBJECTIVE

To establish a relationship between the Visual Analog Scale for pain (VAS) in the recovery time of epidural analgesia and the Perfusion Index (PI) values at that time and to test the possibility of using PI as an objective tool for pain assessment.

METHODS

Thirty women were included in the study. After inserting epidural catheter, the initial applicationtime of epidural analgesia was taken as 0 minute. Hemodinamics, VAS, and PIvalues were recorded at 5, 10, 30, 60 minutes and every two hours until the birth and the 30 minute after the birth.

RESULTS

HR, SAP, DAP, PI, VAS values before the procedure were different than all follow-ups (p<0.001). A negative and significant correlation was found at 10, 30, 60 minutes and 2 hour after drug administration from epidural catheter(rho:0.38; p:0.03, rho:0.47; p:0.009, rho:0.75; p<0.001, rho:0.46; p:0.009, respectively). As the pain decreased, the perfusion index increased. In 17 patients requiring additional doses, PI increased after the all medications, but a decrease was observed in the VAS values(p<0.05).

CONCLUSIONS

In this study, it was determined that the pain decreased with epidural analgesia, perfusion index increased and the pain level increased significantly when the perfusion index started to decrease.

摘要

目的

建立硬膜外镇痛恢复时间的视觉模拟疼痛评分(VAS)与此时的灌注指数(PI)值之间的关系,并测试将PI用作疼痛评估客观工具的可能性。

方法

30名女性纳入本研究。插入硬膜外导管后,将硬膜外镇痛的初始应用时间记为0分钟。在5、10、30、60分钟时以及直至分娩和分娩后30分钟期间,每两小时记录一次血流动力学、VAS和PI值。

结果

术前的心率、收缩压、舒张压、PI、VAS值与所有随访值均不同(p<0.001)。在硬膜外导管给药后10、30、60分钟和2小时发现存在负向且显著的相关性(相关系数分别为:0.38;p:0.03,0.47;p:0.009,0.75;p<0.001,0.46;p:0.009)。随着疼痛减轻,灌注指数增加。在17名需要追加剂量的患者中,所有药物使用后PI均升高,但VAS值下降(p<0.05)。

结论

在本研究中,确定硬膜外镇痛时疼痛减轻,灌注指数增加,且当灌注指数开始下降时疼痛水平显著升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b93c/6191817/665f81557d78/PJMS-34-1262-g001.jpg

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