出院后术后疼痛的患病率：一项系统评价方案

Prevalence of Postoperative Pain Following Hospital Discharge: Protocol for a Systematic Review.

作者信息

Park Rex, Mohiuddin Mohammed, Arellano Ramiro, Pogatzki-Zahn Esther, Klar Gregory, Gilron Ian

机构信息

Department of Anesthesiology and Perioperative Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada.

Department of Anesthesiology, Critical Care Medicine and Pain Therapy, University Hospital Muenster, Muenster, Germany.

出版信息

JMIR Res Protoc. 2020 Dec 4;9(12):e22437. doi: 10.2196/22437.

DOI:10.2196/22437

PMID:33275105

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7748962/

Abstract

BACKGROUND

Pain is one of the most common, feared, and unpleasant symptoms associated with surgery. However, there is a clear gap in patient care after surgical patients are discharged from hospital, resulting in poorly controlled postoperative pain. Inadequate pain management after discharge can have detrimental effects on quality of life and lead to the development of chronic postsurgical pain. The severity of postoperative pain before discharge is well described, but less emphasis has been placed on assessing pain at home after hospital discharge.

OBJECTIVE

The objective of this review is to summarize the prevalence of moderate-to-severe postoperative pain within the first 1 to 14 days after hospital discharge.

METHODS

A detailed search of epidemiological studies investigating postoperative pain will be conducted on MEDLINE and EMBASE from their inception until the date the searches are run. The primary outcome will be the proportion of patients reporting moderate-to-severe postoperative pain at rest and with movement within the first 1 to 14 days after hospital discharge. The secondary outcomes will include a comparison of postoperative pain after discharge between patients who underwent ambulatory and inpatient surgery, and adverse outcomes attributable to poor pain control after hospital discharge (eg, readmission to hospital, emergency room or other unplanned medical visits, or a decrease in quality of life).

RESULTS

The protocol has been registered in PROSPERO (registration number CRD42020194346). The search strategies for MEDLINE and EMBASE have been completed. The final results are expected to be published in May 2021.

CONCLUSIONS

This systematic review is expected to synthesize evidence describing the prevalence of postoperative pain after hospital discharge. Available epidemiological evidence may help inform the magnitude of the problem of postoperative pain at home after hospital discharge.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42020194346; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=194346.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/22437.

摘要

背景

疼痛是与手术相关的最常见、最令人恐惧且最不适的症状之一。然而，手术患者出院后的护理存在明显差距，导致术后疼痛控制不佳。出院后疼痛管理不足会对生活质量产生不利影响，并导致慢性术后疼痛的发生。出院前术后疼痛的严重程度已有充分描述，但对出院后在家中疼痛的评估关注较少。

目的

本综述的目的是总结出院后1至14天内中重度术后疼痛的患病率。

方法

将对MEDLINE和EMBASE从创刊至检索日期进行详细检索，以查找调查术后疼痛的流行病学研究。主要结局将是出院后1至14天内报告静息和活动时中重度术后疼痛的患者比例。次要结局将包括比较门诊手术和住院手术患者出院后的术后疼痛情况，以及出院后疼痛控制不佳导致的不良结局（如再次入院、急诊或其他非计划医疗就诊，或生活质量下降）。