Berardinelli Daniela, Zennaro Dennis, Rizzo Anella, Passet Federico, Sasso Luigia, Di Giulio Paola
SCDO Cardiologia AOU S.Luigi Gonzaga, Orbassano, Torino.
SC Cardiologia U AOU Città della Salute e della Scienza di Torino.
Prof Inferm. 2019 Jun-Sep;72(3):181-186. doi: 10.7429/pi.2019.723186.
Coronary interventions and electrophysiology procedures may be painful both during and shortly after the procedure.
To assess the onset of pain and anxiety in patient undergoing coronary interventions and electrophysiology procedures; to describe the administration (frequency, timing, dosage and outcomes) of analgesics and anxiolytics before, during and after the procedure.
A descriptive multicenter study was carried out. Pain and anxiety were measured with a 10-point visual analogue scale (VAS) before, during, after the procedure and for the following 24 hours. Patient were asked to rate their satisfaction for the information received and pain control.
Data on 230 patients were collected. The most performed procedure was the transradial coronary catheterization (68.7%). The pacemaker/defibrillator implantation resulted the most painful procedure (median 4, IQR 3-6) and also the most anxious (median 5, IQR 2-6). 13 Patients received an analgesic during the procedure for a low-to-severe pain; during the following 24 hours 34 patients (5 undergoing transradial coronary catheterization and 29 the implant of pacemaker/cardiac-defibrillator) suffered from severe pain and with the exception of 5, all requested pain relief. Satisfaction for pain control was inadequate for patients who underwent electrophysiology procedures and 55 patients would have needed more information on pain.
Pain control and patient satisfaction may be improved, pre-procedural anxiety needs more attention and better information on the procedure should be provided.
冠状动脉介入治疗和电生理手术在术中及术后短时间内可能会引起疼痛。
评估接受冠状动脉介入治疗和电生理手术患者的疼痛和焦虑发作情况;描述手术前、术中及术后镇痛药和抗焦虑药的使用情况(频率、时间、剂量和效果)。
开展一项描述性多中心研究。在手术前、术中、术后及术后24小时,采用10分视觉模拟量表(VAS)测量疼痛和焦虑程度。询问患者对所获信息及疼痛控制的满意度。
收集了230例患者的数据。最常进行的手术是经桡动脉冠状动脉导管插入术(68.7%)。起搏器/除颤器植入术是最疼痛的手术(中位数4,四分位间距3 - 6),也是最令人焦虑的手术(中位数5,四分位间距2 - 6)。13例患者在术中因轻至重度疼痛接受了镇痛药治疗;在随后的24小时内,34例患者(5例接受经桡动脉冠状动脉导管插入术,29例植入起搏器/心脏除颤器)遭受重度疼痛,除5例患者外,其余患者均要求缓解疼痛。接受电生理手术的患者对疼痛控制的满意度不足,55例患者需要更多关于疼痛的信息。
可以改善疼痛控制和患者满意度,术前焦虑需要更多关注,应提供关于手术的更好信息。