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重症监护病房中程序性疼痛的管理。

Management of procedural pain in the intensive care unit.

作者信息

Guo Na-Na, Wang Hong-Liang, Zhao Ming-Yan, Li Jian-Guo, Liu Hai-Tao, Zhang Ting-Xin, Zhang Xin-Yu, Chu Yi-Jun, Yu Kai-Jiang, Wang Chang-Song

机构信息

Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China.

Department of Critical Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, Heilongjiang Province, China.

出版信息

World J Clin Cases. 2022 Feb 16;10(5):1473-1484. doi: 10.12998/wjcc.v10.i5.1473.

Abstract

Pain is a common experience for inpatients, and intensive care unit (ICU) patients undergo more pain than other departmental patients, with an incidence of 50% at rest and up to 80% during common care procedures. At present, the management of persistent pain in ICU patients has attracted considerable attention, and there are many related clinical studies and guidelines. However, the management of transient pain caused by certain ICU procedures has not received sufficient attention. We reviewed the different management strategies for procedural pain in the ICU and reached a conclusion. Pain management is a process of continuous quality improvement that requires multidisciplinary team cooperation, pain-related training of all relevant personnel, effective relief of all kinds of pain, and improvement of patients' quality of life. In clinical work, which involves complex and diverse patients, we should pay attention to the following points for procedural pain: (1) Consider not only the patient's persistent pain but also his or her procedural pain; (2) Conduct multimodal pain management; (3) Provide combined sedation on the basis of pain management; and (4) Perform individualized pain management. Until now, the pain management of procedural pain in the ICU has not attracted extensive attention. Therefore, we expect additional studies to solve the existing problems of procedural pain management in the ICU.

摘要

疼痛是住院患者的常见经历,重症监护病房(ICU)患者比其他科室患者遭受更多疼痛,休息时发生率为50%,在常见护理操作期间高达80%。目前,ICU患者持续性疼痛的管理已引起相当关注,并有许多相关临床研究和指南。然而,由某些ICU操作引起的短暂性疼痛的管理尚未得到充分重视。我们回顾了ICU中程序性疼痛的不同管理策略并得出结论。疼痛管理是一个持续质量改进的过程,需要多学科团队合作、对所有相关人员进行疼痛相关培训、有效缓解各种疼痛以及提高患者生活质量。在涉及复杂多样患者的临床工作中,对于程序性疼痛我们应注意以下几点:(1)不仅要考虑患者的持续性疼痛,还要考虑其程序性疼痛;(2)进行多模式疼痛管理;(3)在疼痛管理基础上提供联合镇静;(4)实施个体化疼痛管理。到目前为止,ICU中程序性疼痛的管理尚未引起广泛关注。因此,我们期待更多研究来解决ICU中程序性疼痛管理存在的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4cc/8855268/04f0cc9bd20c/WJCC-10-1473-g001.jpg

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