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法国急诊科手术疼痛评估:一项针对轻度创伤患者的多中心、非干预性横断面研究。

Assessment of procedural pain in French emergency departments: a multi-site, non-interventional, transverse study in patients with minor trauma injury.

作者信息

Truchot Jennifer, Mezaïb Karima, Ricard-Hibon Agnès, Vicaut Eric, Claessens Yann-Erick, Soulat Louis, Milon Jean-Yves, Serrie Alain, Plaisance Patrick

机构信息

Department of Emergency Medicine, Lariboisière University Hospital, AP-HP, Paris Diderot University , Paris , France.

Department of Pain Medicine, Institut Gustave Roussy , Villejuif , France.

出版信息

Hosp Pract (1995). 2019 Aug;47(3):143-148. doi: 10.1080/21548331.2019.1646074. Epub 2019 Aug 5.

Abstract

: To determine the mean number of procedural painful episodes per patient, and to retrieve information regarding diagnosis, therapeutic procedures and analgesic management, in patients visiting Emergency Departments (EDs) for minor trauma. : This observational, non-interventional, multicenter study in adult patients was performed in 35 French EDs. All patients entering the EDs for minor trauma on a specified day between noon and 10 pm were registered; consenting patients were included in the study. Pain intensity was assessed using a verbal Numerical Rating Scale from 0 (no pain) to 10 (worst possible pain). An episode was described as painful if the difference in pain intensity between pain just before the procedure and maximal pain during the procedure was ≥2. Two independent nurses recorded data on 1 day in each center. : Overall, 909 patients were registered, 422 were included in the study, and complete data for 409 patients (1899 procedures) were available for analysis. The mean number of painful episodes per patient was 1.0 ± 1.3. Fifty-one percent of patients reported at least one painful procedure episode. Twenty-one percent of procedures were considered painful. Clinical examination was the procedure most often reported as painful. No preventive or curative analgesic treatment was reported in 95.1% of procedures. : There is a need for improvement in routine pain assessment and, therefore, procedural pain management for ED patients. Specific protocols should be developed for procedural pain management, and teams should be trained especially for procedures usually not considered painful.

摘要

为确定每位患者程序性疼痛发作的平均次数,并获取有关诊断、治疗程序和镇痛管理的信息,对因轻度创伤就诊于急诊科(ED)的患者进行研究。:这项针对成年患者的观察性、非干预性多中心研究在法国的35家急诊科开展。登记了在指定日期中午至晚上10点之间因轻度创伤进入急诊科的所有患者;同意参与研究的患者被纳入。使用从0(无疼痛)至10(最严重疼痛)的言语数字评定量表评估疼痛强度。如果操作前的疼痛与操作期间的最大疼痛之间的疼痛强度差异≥2,则将一次发作描述为疼痛发作。两名独立护士在每个中心的一天记录数据。:总体而言,登记了909名患者,422名患者被纳入研究,409名患者(1899次操作)的完整数据可用于分析。每位患者疼痛发作的平均次数为1.0±1.3。51%的患者报告至少有一次疼痛的操作发作。21%的操作被认为是疼痛的。临床检查是最常被报告为疼痛的操作。95.1%的操作未报告预防性或治疗性镇痛治疗。:急诊科患者的常规疼痛评估以及因此的程序性疼痛管理需要改进。应为程序性疼痛管理制定具体方案,并且应为通常不被认为疼痛的操作对团队进行专门培训。

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