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妇科手术后阿片类药物自控镇痛期间使用无线呼吸频率传感器监测:一项前瞻性队列研究。

Use of wireless respiratory rate sensor monitoring during opioid patient-controlled analgesia after gynaecological surgery: A prospective cohort study.

作者信息

Cheng Shang-Ming, Chan Jason Ju In, Tan Chin Wen, Lu Enhong, Sultana Rehena, Sng Ban Leong

机构信息

Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore.

Anaesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore.

出版信息

Indian J Anaesth. 2021 Feb;65(2):146-152. doi: 10.4103/ija.IJA_1262_20. Epub 2021 Feb 10.

Abstract

BACKGROUND AND AIMS

Respiratory depression is a rare but serious complication during opioid administration. Therefore, early detection of signs of deterioration is paramount. The current standard of care of using manual intermittent respiratory rate (RR) measurement is labour intensive and inefficient. We evaluated a wireless sensor monitor, Aingeal (Renew Health Ltd, Ireland), to continuously monitor RR, heart rate (HR) and temperature compared to standard clinical measurements.

METHODS

Patients who underwent major gynaecological operations and received postoperative opioid patient-controlled analgesia were recruited. Patients were connected to the sensor monitor via a central station software platform. The primary outcome was comparison of RR between sensor and nursing monitoring, with secondary outcomes being HR and temperature between two methods. Feedback from patients and healthcare providers was also collected. Bland-Altman analyses were used to compare the vital signs recorded in sensor against those in patient's electronic record.

RESULTS

A total of 1121 hours of vital signs data were analysed. Bias for RR was -0.90 (95% confidence interval (CI): -9.39, 7.60) breaths/min between nursing and averaged sensor readings. Bias for heart rate was -1.12 (95% CI: -26.27, 24.03) and bias for temperature was 1.45 (95% CI: -5.67, 2.76) between the two methods.

CONCLUSION

There is satisfactory agreement of RR measurements, as well as HR and temperature measurements, by the wireless sensor monitor with standard clinical intermittent monitoring with overall good user experience.

摘要

背景与目的

呼吸抑制是阿片类药物给药过程中一种罕见但严重的并发症。因此,早期发现病情恶化迹象至关重要。目前使用手动间歇性测量呼吸频率(RR)的护理标准既耗费人力又效率低下。我们评估了一种无线传感器监测仪Aingeal(爱尔兰Renew Health有限公司),将其与标准临床测量方法进行比较,以持续监测RR、心率(HR)和体温。

方法

招募接受大型妇科手术并接受术后阿片类药物自控镇痛的患者。通过中央站软件平台将患者连接到传感器监测仪。主要结局是比较传感器监测与护理监测的RR,次要结局是两种方法之间的HR和体温。还收集了患者和医护人员的反馈。采用Bland-Altman分析比较传感器记录的生命体征与患者电子记录中的生命体征。

结果

共分析了1121小时的生命体征数据。护理与传感器平均读数之间RR的偏差为-0.90(95%置信区间(CI):-9.39,7.60)次/分钟。两种方法之间心率的偏差为-1.12(95%CI:-26.27,24.03),体温的偏差为1.45(95%CI:-5.67,2.76)。

结论

无线传感器监测仪测量的RR、HR和体温与标准临床间歇性监测结果具有令人满意的一致性,总体用户体验良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a90e/7983829/211b1280b301/IJA-65-146-g001.jpg

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