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外周神经阻滞与术后即刻恢复:一项关于麻醉后护理人员偏好和意见的单机构调查

Peripheral Nerve Blocks and Immediate Postoperative Recovery: A Single-Institution Survey of Perianesthesia Nurses' Preferences and Opinions.

作者信息

McClain Robert L, Porter Steven B, Scott Courtney L, Mazer Laura S, Robards Christopher B

出版信息

J Perianesth Nurs. 2019 Oct;34(5):965-970.e6. doi: 10.1016/j.jopan.2019.02.006. Epub 2019 May 29.

DOI:10.1016/j.jopan.2019.02.006
PMID:31153776
Abstract

PURPOSE

To ascertain the preferences of perianesthesia nurses regarding peripheral nerve blocks (PNBs) and their impact on patient recovery after total joint replacement (TJR).

DESIGN

Survey of perianesthesia nurses at a single medical center.

METHODS

Fifty-nine perianesthesia nurses completed a 23-question survey on PNBs for TJR.

FINDINGS

Most agreed PNBs improved patients' pain after knee, hip, and shoulder TJR (35 [92.1%], 35 [92.1%], and 34 [91.9%], respectively). Most felt lower extremity PNBs increased risk of falling (26 [70.3%]), whereas 7 of 35 (20.0%) felt patients fell more after spinal anesthesia than after general anesthesia. Respondents preferred a block to opioid-based analgesia if they were to have lower extremity TJR or total shoulder replacement (100% [30/30 and 33/33]).

CONCLUSIONS

The perianesthesia nurses surveyed felt PNBs improved pain control and patient recovery despite a perceived risk of falling for lower extremity TJR, and they preferred PNB when considering TJR surgery for themselves.

摘要

目的

确定麻醉后护理护士对周围神经阻滞(PNB)的偏好及其对全关节置换术(TJR)后患者恢复的影响。

设计

对单一医疗中心的麻醉后护理护士进行调查。

方法

59名麻醉后护理护士完成了一项关于TJR的PNB的23个问题的调查。

结果

大多数人同意PNB改善了膝关节、髋关节和肩关节TJR后的患者疼痛(分别为35例[92.1%]、35例[92.1%]和34例[91.9%])。大多数人认为下肢PNB增加了跌倒风险(26例[70.3%]),而35人中有7人(20.0%)认为患者脊髓麻醉后比全身麻醉后跌倒更多。如果进行下肢TJR或全肩关节置换术,受访者更喜欢神经阻滞而非基于阿片类药物的镇痛(100%[30/30和33/33])。

结论

接受调查的麻醉后护理护士认为,尽管下肢TJR存在跌倒风险,但PNB改善了疼痛控制和患者恢复,并且在考虑自身TJR手术时他们更喜欢PNB。

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