基于即时通讯软件的术前疼痛管理模式在老年髋部骨折患者中的应用：一项随机对照试验。

Application of a preoperative pain management mode based on instant messaging software in elderly hip fracture patients: a randomized controlled trial.

机构信息

Department of Emergency Medicine, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning Province, China.

Department of Anesthesiology, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning Province, China.

出版信息

BMC Geriatr. 2023 Mar 30;23(1):186. doi: 10.1186/s12877-023-03905-2.

DOI:10.1186/s12877-023-03905-2

PMID:36991402

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10061705/

Abstract

BACKGROUND

Preoperative analgesia of hip fracture in elderly patients is important, but it is also lacking. In particular, nerve block was not provided in time. In order to provide more effective analgesia, we designed a multimodal pain management mode based on instant messaging software.

METHODS

From May to September 2022, a total of 100 patients with unilateral hip fracture aged over 65 were randomly divided into the test group and the control group. Finally, 44 patients in each group completed the result analysis. A new pain management mode was used in the test group. This mode focuses on the full information exchange between medical personnel in different departments, early fascia iliaca compartment block (FICB), and closed-loop pain management. Outcomes include the time when FICB is completed for the first time; The number of cases of FICB completed by emergency doctors; Patients' pain score, pain duration.

RESULTS

The time for patients in the test group to complete FICB for the first time was 3.0 [1.925-3.475] h, which was less than the time for patients in the control group (4.0 [3.300-5.275] h). The difference was statistically significant (P < 0.001). Compared with 16 patients in the control group, 24 patients in the test group completed FICB by emergency doctors, and there was no statistical difference between the two groups (P = 0.087). The test group was superior to the control group in the highest NRS score (4.00 [3.00-4.00] vs 5.00 [4.00-5.75]), the duration of the highest NRS score (20.00 [20.00-25.00] mins vs 40.00 [30.00-48.75] mins), and the NRS > 3 time (35.00 [20.00-45.00] mins vs 72.50 [60.00-45.00] mins). The analgesic satisfaction of patients in the test group (5.00 [4.00-5.00]) was also significantly higher than that of the control group (3.00 [3.00-4.00]). The above four indexes were different between the two groups (P < 0.001).

CONCLUSIONS

Using instant messaging software, the new model of pain management can enable patients to receive FICB as soon as possible and improve the timeliness and effectiveness of analgesia.

TRIAL REGISTRATION

Chinese Clinical Registry Center, ChiCTR2200059013, 23/04/2022.

摘要

背景

老年髋部骨折患者的术前镇痛很重要，但往往也会有所缺失。特别是神经阻滞不能及时进行。为了提供更有效的镇痛，我们设计了一种基于即时通讯软件的多模式疼痛管理模式。

方法

2022 年 5 月至 9 月，共纳入 100 例年龄>65 岁的单侧髋部骨折患者，随机分为试验组和对照组，最终每组各有 44 例患者完成结果分析。试验组采用新的疼痛管理模式，该模式侧重于不同科室医务人员之间的充分信息交流、早期股外侧皮神经阻滞（FICB）和闭环疼痛管理。结果包括首次完成 FICB 的时间；完成 FICB 的急诊医生人数；患者疼痛评分、疼痛持续时间。

结果

试验组患者首次完成 FICB 的时间为 3.0[1.925-3.475]h，短于对照组（4.0[3.300-5.275]h），差异具有统计学意义（P<0.001）。与对照组的 16 例患者相比，试验组的 24 例患者由急诊医生完成 FICB，两组之间无统计学差异（P=0.087）。在最高 NRS 评分（4.00[3.00-4.00]vs 5.00[4.00-5.75]）、最高 NRS 评分持续时间（20.00[20.00-25.00]min vs 40.00[30.00-48.75]min）和 NRS>3 时间（35.00[20.00-45.00]min vs 72.50[60.00-45.00]min）方面，试验组优于对照组。试验组患者的镇痛满意度（5.00[4.00-5.00]）也明显高于对照组（3.00[3.00-4.00]）。两组上述四项指标均有差异（P<0.001）。