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探索疼痛敏感问卷对剖宫产术后静脉镇痛指导作用的随机双盲对照试验

Exploring the Effect of Pain Sensitive Questionnaire on Guiding Intravenous Analgesia After Cesarean Section: A Randomised Double Blind Controlled Trial.

作者信息

Liu Shuxin, Liu Siqi, Gu Dengfeng, Zhao Xiaona, Zhang Hong, Deng Chao, Gu Yajuan

机构信息

Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People's Republic of China.

Department of Obstetrics, First Affiliated Hospital, Shihezi University, Shihezi, People's Republic of China.

出版信息

J Pain Res. 2023 Sep 18;16:3185-3196. doi: 10.2147/JPR.S412131. eCollection 2023.

Abstract

OBJECTIVE

This study investigates the effect of the Pain Sensitivity Questionnaire (PSQ) in guiding patient controlled intravenous analgesia (PCIA) on postoperative analgesia in women undergoing cesarean section.

METHODS

A total of 160 women who were to undergo a cesarean section under combined spinal and epidural anaesthesia were included in this study. Women with a preoperative PSQ <4 were randomly divided into a low pain-sensitive control group (LC group), and a low pain-sensitive observation group (LO group), and women with preoperative PSQ >6 were randomly divided into a high pain-sensitive control group (HC group) and a high pain-sensitive observation group (HO group). After the surgery, patients received the pump butorphanol concentration was 3.5 µg·kg·h in the LC and HC groups, 3.0 µg·kg·h in the LO group and 4.0 µg·kg·h in the HO group.To compare the analgesic effects of postoperative PCIA and postoperative recovery in women.

RESULTS

Wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the LC group than in the LO group at 4 and 8 h postoperatively (P<0.05). Similarly, wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the HO group than in the HC group at 8, 12, and 24 h postoperatively (P<0.05). The Ramsay scores were significantly higher in the LC than in the LO groups at 4, 8, 12, 24, and 48 h postoperatively (P<0.05), but there was no statistically significant difference between the Ramsay scores in the HC group and the HO group. There was no statistical difference in any of the post-operative recoveries (P>0.05).

CONCLUSION

Compared to the weight-based postoperative PCIA, the PSQ-based postoperative PCIA has better analgesic effects and can improve maternal satisfaction with postoperative analgesia.

摘要

目的

本研究探讨疼痛敏感性问卷(PSQ)指导剖宫产术后患者自控静脉镇痛(PCIA)的效果。

方法

本研究纳入160例拟在腰麻-硬膜外联合麻醉下行剖宫产术的女性。术前PSQ<4的女性被随机分为低疼痛敏感性对照组(LC组)和低疼痛敏感性观察组(LO组),术前PSQ>6的女性被随机分为高疼痛敏感性对照组(HC组)和高疼痛敏感性观察组(HO组)。术后,LC组和HC组患者泵注布托啡诺浓度为3.5μg·kg·h,LO组为3.0μg·kg·h,HO组为4.0μg·kg·h。比较女性术后PCIA的镇痛效果和术后恢复情况。

结果

术后4小时和8小时,LC组静息和活动时的伤口疼痛及子宫收缩疼痛VAS评分显著低于LO组(P<0.05)。同样,术后8、12和24小时,HO组静息和活动时的伤口疼痛及子宫收缩疼痛VAS评分显著低于HC组(P<0.05)。术后4、8、12、24和48小时,LC组的Ramsay评分显著高于LO组(P<0.05),但HC组和HO组的Ramsay评分无统计学差异。术后各项恢复情况均无统计学差异(P>0.05)。

结论

与基于体重的术后PCIA相比,基于PSQ的术后PCIA具有更好的镇痛效果,可提高产妇对术后镇痛的满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/472e/10516306/7bbff10af7e5/JPR-16-3185-g0001.jpg

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