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重症监护病房患者休息时和护理过程中疼痛的发生率:一项纵向观察性研究。

Incidence of pain at rest and during nursing procedures in ICU patients: a longitudinal observational study.

机构信息

Azienda Socio Sanitaria Territoriale of Lecco, Italy - Tor Vergata University, Rome, Italy.

Azienda Socio Sanitaria Territoriale of Lecco, Italy.

出版信息

Ann Ig. 2020 Jul-Aug;32(4):407-418. doi: 10.7416/ai.2020.2364.

Abstract

AIM

To evaluate pain monitoring in surgical and no-surgical ICU patients and to observe the presence of pain at rest and during nursing procedures.

METHODS

A longitudinal, observational study was conducted at an intensive care unit in Italy. Based on the specific conditions of the patient the best rating scale was used (Numerical Rating Scale or the Critical-Care Pain Observation Tool). Two ICU nurses performed pain assessments before and during some nursing procedures that are considered nociceptive.

RESULTS

The pain incidence rate in 1,602 days of observation was 0.06 patient/day (59/1000 days of observation). The incidence rate of intense pain was 0.012 patient/day (12/1000 days of observation). Pain at rest was detected in 67 (27.6%) patients. Pain during procedures was found 134 (36.1%) times. In the 96 patients who were in pain the ICU stay (15.4 days + 7.8 vs 11.4 days + 5.6) and the days of mechanical ventilation (13.4 + 7.9 vs 9.7 + 4.9) was increased. Surgical patients had an increased pain risk than non-surgical patients (RR = 2.7, CI = 2.0-3.6; p<.001).

CONCLUSIONS

The incidence of pain was recorded in 39.5% of ICU patients. However further studies of larger patient samples are needed.

摘要

目的

评估外科和非外科 ICU 患者的疼痛监测情况,并观察患者在休息和护理过程中是否存在疼痛。

方法

这是一项在意大利重症监护病房进行的纵向观察性研究。根据患者的具体情况,使用最佳的评分量表(数字评分量表或重症监护疼痛观察工具)进行疼痛评估。两名 ICU 护士在一些被认为是伤害性的护理操作前后进行疼痛评估。

结果

在 1602 天的观察中,疼痛发生率为 0.06 例/天(59/1000 天的观察)。剧烈疼痛的发生率为 0.012 例/天(12/1000 天的观察)。在 67 例(27.6%)患者中发现存在静息痛。在 134 次(36.1%)护理操作中发现存在疼痛。在 96 例疼痛患者中,ICU 住院时间(15.4 天+7.8 天 vs 11.4 天+5.6 天)和机械通气天数(13.4 天+7.9 天 vs 9.7 天+4.9 天)均增加。外科患者的疼痛风险高于非外科患者(RR=2.7,CI=2.0-3.6;p<.001)。

结论

39.5%的 ICU 患者有疼痛记录。但需要对更大的患者样本进行进一步研究。

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