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[氧化亚氮与氧气混合吸入技术在中重度烧伤患儿清创换药时镇痛镇静中的应用效果]

[Application effects of nitrous oxide and oxygen mixed inhalation technology on analgesia and sedation during debridement and dressing change in children with moderate or severe burns].

作者信息

Fan T T, Han M, Liang Y, Cao G H, Song G D

机构信息

Cheeloo College of Medicine, Shandong University, Jinan 250012, China Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China.

Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China.

出版信息

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Mar 20;39(3):248-255. doi: 10.3760/cma.j.cn501225-20220308-00051.

Abstract

To investigate the application effects of nitrous oxide and oxygen mixed inhalation technology on analgesia and sedation during debridement and dressing change in children with moderate or severe burns. A retrospective non-randomized contemporary controlled study was conducted. From December 2019 to November 2021, 140 burn children with moderate or severe burns, aged 1 to 3 years, who met the inclusion criteria were admitted to Central Hospital Affiliated to Shandong First Medical University. During debridement and dressing change 3 to 14 days after injury, 42 children, including 23 males and 19 females, who received nurse-centered pain management mode and analgesia and sedation with nitrous oxide and oxygen mixed inhalation technology were included in nitrous oxide group (the dressing change process using the above-mentioned technology for the first time was selected for the follow-up study). Another 42 children, including 24 males and 18 females, were included in non-nitrous oxide group from 98 children who did not apply analgesia or sedation treatment during dressing change with stratified random sampling (one dressing change process was randomly selected for the follow-up study). The face, legs, activity, cry, and consolability scale and Ramsay sedation scale were used to evaluate the pain intensity and degree of sedation, respectively, at 30 minutes before dressing change (hereinafter referred to as before dressing change), immediately after debridement, and at 30 minutes after finishing dressing change (hereinafter referred to as after dressing change). After dressing change, the self-made satisfaction scale was used to evaluate the satisfaction degree of dressing change surgeons and guardians of children for analgesic effects during dressing change. The duration of dressing change and the healing time of deep partial-thickness burn wounds were recorded. The heart rate and percutaneous arterial oxygen saturation (SpO) before, during, and after dressing change and the occurrence of adverse events such as nausea and vomiting during dressing change were recorded. Data were statistically analyzed with Mann-Whitney test, chi-square test, analysis of variance for repeated measurement, independent sample test, and Bonferroni correction. There were no significant differences in the score of pain intensity and score of sedation degree between children in two groups before and after dressing change (>0.05). Immediately after debridement, the score of pain intensity of children in nitrous oxide group was 2.5±0.7, which was significantly lower than 7.6±1.0 in non-nitrous oxide group (=-26.69, <0.05); the score of sedation degree of children in nitrous oxide group was 1.83±0.38, which was significantly higher than 1.21±0.42 in non-nitrous oxide group (=7.15, <0.05). After dressing change, the satisfaction degree scores of dressing change surgeons and guardians of children for analgesic effects during dressing change of children in nitrous oxide group were significantly higher than those in non-nitrous oxide group (with values of 10.53 and 2.24, respectively, <0.05). The dressing change duration of children in nitrous oxide group was significantly shorter than that in non-nitrous oxide group (=-5.33, <0.05). The healing time of deep partial-thickness burn wounds in children between the two groups had no significant difference (>0.05). The heart rate of children in nitrous oxide group was significantly lower than that in non-nitrous oxide group during dressing change (=-12.40, <0.05), while the SpO was significantly higher than that in non-nitrous oxide group (=5.98, <0.05). During dressing change, 2 children had nausea and 1 child had euphoria in nitrous oxide group, while heart rate of all children in non-nitrous oxide group continued to be higher than the normal range. In the process of debridement and dressing change in children with moderate or severe burns, the use of nurse-centered pain management mode and the standardized use of nitrous oxide and oxygen mixed inhalation technology can safely and effectively control pain and sedation.

摘要

探讨氧化亚氮与氧气混合吸入技术在中重度烧伤患儿清创换药过程中的镇痛镇静应用效果。进行一项回顾性非随机同期对照研究。选取2019年12月至2021年11月期间,山东第一医科大学附属中心医院收治的140例年龄1至3岁、符合纳入标准的中重度烧伤患儿。在伤后3至14天进行清创换药时,将42例患儿纳入氧化亚氮组(其中男23例,女19例),这些患儿采用以护士为中心的疼痛管理模式,并使用氧化亚氮与氧气混合吸入技术进行镇痛镇静(选取首次使用上述技术的换药过程进行随访研究)。另外,从98例换药时未应用镇痛或镇静治疗的患儿中,通过分层随机抽样选取42例患儿纳入非氧化亚氮组(随机选取一次换药过程进行随访研究),其中男24例,女18例。分别于换药前30分钟(以下简称换药前)、清创结束即刻、换药结束后30分钟(以下简称换药后),采用面部、腿部、活动、哭闹及安慰量表和Ramsay镇静量表评估疼痛强度和镇静程度。换药后,采用自制满意度量表评估换药医生和患儿监护人对换药过程中镇痛效果的满意度。记录换药持续时间及深Ⅱ度烧伤创面愈合时间。记录换药前、换药过程中及换药后的心率和经皮动脉血氧饱和度(SpO),以及换药过程中恶心、呕吐等不良事件的发生情况。采用Mann-Whitney检验、卡方检验、重复测量方差分析、独立样本检验及Bonferroni校正进行统计学分析。两组患儿换药前后疼痛强度评分和镇静程度评分比较,差异均无统计学意义(>0.05)。清创结束即刻,氧化亚氮组患儿疼痛强度评分为2.5±0.7,显著低于非氧化亚氮组的7.6±1.0(=-26.69,<0.05);氧化亚氮组患儿镇静程度评分为1.83±0.38,显著高于非氧化亚氮组的1.21±0.42(=7.15,<0.05)。换药后,氧化亚氮组患儿换药医生和患儿监护人对换药过程中镇痛效果的满意度评分显著高于非氧化亚氮组(分别为10.53和2.24,<0.05)。氧化亚氮组患儿换药持续时间显著短于非氧化亚氮组(=-5.33,<0.05)。两组患儿深Ⅱ度烧伤创面愈合时间比较差异无统计学意义(>0.05)。换药过程中,氧化亚氮组有2例患儿出现恶心,1例患儿出现欣快感,而非氧化亚氮组所有患儿心率持续高于正常范围。在中重度烧伤患儿清创换药过程中,采用以护士为中心的疼痛管理模式并规范使用氧化亚氮与氧气混合吸入技术,可安全有效地控制疼痛和镇静。

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本文引用的文献

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Nitrous Oxide: an emerging novel treatment for treatment-resistant depression.
J Neurol Sci. 2022 Mar 15;434:120092. doi: 10.1016/j.jns.2021.120092. Epub 2021 Dec 16.
2
[Research advances on assisted analgesic and sedative treatment of burn children].
Zhonghua Shao Shang Za Zhi. 2020 Oct 20;36(10):979-982. doi: 10.3760/cma.j.cn501120-20190731-00327.
3
Management of severe thermal burns in the acute phase in adults and children.
Anaesth Crit Care Pain Med. 2020 Apr;39(2):253-267. doi: 10.1016/j.accpm.2020.03.006. Epub 2020 Mar 5.
5
[Advances in the research of pain assessment and non-drug intervention in burn children].
Zhonghua Shao Shang Za Zhi. 2020 Jan 20;36(1):76-80. doi: 10.3760/cma.j.issn.1009-2587.2020.01.015.
7
Office-Based Anesthesia: A Comprehensive Review and 2019 Update.
Anesthesiol Clin. 2019 Jun;37(2):317-331. doi: 10.1016/j.anclin.2019.01.004. Epub 2019 Mar 22.
9
ISBI Practice Guidelines for Burn Care, Part 2.
Burns. 2018 Nov;44(7):1617-1706. doi: 10.1016/j.burns.2018.09.012. Epub 2018 Oct 19.
10
[Management of analgesia and sedation in critically burned adult patients].
Zhonghua Shao Shang Za Zhi. 2018 Jun 20;34(6):407-411. doi: 10.3760/cma.j.issn.1009-2587.2018.06.022.

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