Seth Crockett, MD, MPH, is Associate Professor of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill.
Evan S. Dellon, MD, MPH, is Professor of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill.
Gastroenterol Nurs. 2021;44(2):136-145. doi: 10.1097/SGA.0000000000000550.
Work-related musculoskeletal disorders occur frequently among the endoscopy staff, and patient-handling duties involved with colonoscopy-applying manual pressure and repositioning patients-are particularly physically demanding. This study explored whether the use of a lower abdominal compression device (ColoWrap), previously shown to reduce the need for manual pressure and patient repositioning, would diminish the frequency of staff-reported musculoskeletal pain. A randomized, blinded, sham-controlled clinical trial was performed at the University of North Carolina Hospitals. Three hundred fifty patients had either ColoWrap or a sham device applied before colonoscopy. The primary outcome was the frequency of staff-reported musculoskeletal pain after assisting with colonoscopy. In the intention-to-treat analysis, which included procedures in which ColoWrap was removed, there was no statistical difference in the frequency of staff-reported pain in the control versus ColoWrap arm (4.6% vs. 3.4% of procedures, p = .59). However, when ColoWrap was used as directed (e.g., remained in place for the duration of the procedure), the frequency of staff-reported musculoskeletal pain was significantly reduced (4.6% vs. 0.7% of procedures, p = 0.04). Use of ColoWrap as directed was also found to be independently associated with reduced odds of staff-reported pain relative to the sham arm (OR = 0.12; 95% CI [0.02, 0.95]). When used as directed, ColoWrap reduced the frequency of musculoskeletal pain experienced related to assisting with colonoscopy and may reduce the risk of musculoskeletal disorders and injuries among the endoscopy staff.
工作相关的肌肉骨骼疾病在内镜工作人员中很常见,而结肠镜检查中涉及的患者处理职责,如手动施压和重新安置患者,对体力的要求特别高。本研究探讨了先前已证明可减少手动施压和患者重新安置需求的下腹部压缩装置(ColoWrap)的使用是否会降低工作人员报告的肌肉骨骼疼痛的频率。该研究在北卡罗来纳大学医院进行了一项随机、双盲、假对照临床试验。350 名患者在结肠镜检查前接受了 ColoWrap 或假设备的治疗。主要结局是协助结肠镜检查后工作人员报告的肌肉骨骼疼痛的频率。在包括 ColoWrap 被移除的手术的意向治疗分析中,对照组与 ColoWrap 组的工作人员报告疼痛的频率没有统计学差异(分别为 4.6%和 3.4%的手术,p =.59)。然而,当 ColoWrap 按指示使用(例如,在手术过程中一直保留在原位)时,工作人员报告的肌肉骨骼疼痛的频率显著降低(分别为 4.6%和 0.7%的手术,p = 0.04)。按指示使用 ColoWrap 还被发现与相对于假设备臂工作人员报告疼痛的几率降低独立相关(OR = 0.12;95%CI [0.02, 0.95])。当按指示使用时,ColoWrap 降低了与协助结肠镜检查相关的肌肉骨骼疼痛的频率,并可能降低内镜工作人员肌肉骨骼疾病和损伤的风险。