Departamento de Enfermería, Universidad de Sevilla, Seville, Spain.
Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Seville, Spain.
Nurs Crit Care. 2022 Mar;27(2):223-232. doi: 10.1111/nicc.12614. Epub 2021 Feb 28.
Despite increased attention, acute and persistent post-operative pain are not treated efficiently and interventions against acute pain are therefore of clinical importance and should be welcomed.
To evaluate the effectiveness of wound infiltration with 0.5% bupivacaine for pain management in the immediate post-operative period in patients that underwent cardiac surgery with sternotomy.
The study was performed employing a single-centre nonrandomized experimental design to evaluate a prospective cohort of patients recruited from June to December of 2017.
A single-centre study with a non-randomized experimental design compared the pain perceived by 137 patients undergoing to cardiac surgery within which 68 patients who received infiltration of bupivacaine and 69 patients received infiltration with saline solution. Pain measures were made with the numeric rating scale (NRS) at 2, 12, 24, and 48 hours. Socio-demographic and clinical variables were included too and descriptive, bivariate, and multivariate logistic regression analyses were performed.
A statistically significant difference was found between the means of the NRS scores in favour of the intervention group. Cohen's d showed a significant effect size. NRS scores were grouped into NRS ≥4 or NRS <4 and similar results were found. Multivariate logistic regression analyses showed the absence of confounding factors that could call results into question.
Subcutaneous infiltration of 0.5% bupivacaine in the surgical site of patients who have undergone cardiac surgery showed clinically and statistically significant pain relief compared with patients who received saline infiltration throughout the first 12 hours after surgery. This intervention provides promising preliminary results that, alone or in conjunction with other nursing interventions, could constitute an important therapeutic tool for this area of nursing clinical practice.
尽管人们越来越关注，但急性和持续性术后疼痛仍未得到有效治疗，因此针对急性疼痛的干预措施具有重要的临床意义，应该受到欢迎。
评估 0.5%布比卡因用于胸骨切开术后心脏手术患者即刻术后疼痛管理的效果。
本研究采用单中心非随机实验设计，评估 2017 年 6 月至 12 月期间招募的前瞻性队列患者。
一项单中心研究采用非随机实验设计，比较了 137 例接受心脏手术的患者的疼痛，其中 68 例患者接受布比卡因浸润，69 例患者接受生理盐水浸润。在 2、12、24 和 48 小时使用数字评分量表（NRS）测量疼痛。还包括社会人口统计学和临床变量，并进行描述性、双变量和多变量逻辑回归分析。
干预组的 NRS 评分均值存在统计学显著差异，有利于干预组。Cohen's d 显示出显著的效应大小。NRS 评分分为 NRS≥4 或 NRS<4，结果相似。多变量逻辑回归分析表明，不存在可能使结果受到质疑的混杂因素。
与接受生理盐水浸润的患者相比，接受心脏手术后在手术部位皮下浸润 0.5%布比卡因的患者在术后 12 小时内的疼痛缓解具有临床和统计学意义。该干预措施提供了有前景的初步结果，单独或与其他护理干预措施结合使用，可能成为该护理临床实践领域的重要治疗工具。
