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一项关于手术医师和麻醉医师对阿片类药物耐受患者围手术期多模式镇痛的调查研究。

A Survey Study of Surgeons and Anesthesiologists Regarding Perioperative Multimodal Analgesia for Opioid-Tolerant Patients.

机构信息

Department of Anesthesiology and Pain Medicine, Yale University School of Medicine, New Haven, CT.

Department of Anesthesiology and Pain Medicine, Yale University School of Medicine, New Haven, CT.

出版信息

J Perianesth Nurs. 2024 Feb;39(1):87-92. doi: 10.1016/j.jopan.2023.07.001. Epub 2023 Oct 18.

DOI:10.1016/j.jopan.2023.07.001
PMID:37855765
Abstract

PURPOSE

Perioperative pain management of opioid-tolerant patients can be challenging. Although regional anesthesia and multimodal analgesics may be beneficial, these modalities are often underused. It is unclear whether practice patterns for perioperative pain management are determined by the knowledge, attitudes, and beliefs of surgeons and anesthesiologists.

DESIGN

Descriptive survey.

METHODS

Using a Qualtrics survey, we polled a randomly selected group of 25 surgeons and 25 anesthesiologists regarding their knowledge, attitudes, beliefs, and practices for pain management in an opioid-tolerant patient.

FINDINGS

Of 25, 23 anesthesiologists and 18/25 surgeons responded to the survey. Demographics were similar between the 2 groups. Most of the participant surgeons and anesthesiologists believed that pain management may be challenging in an opioid-tolerant patient. However, only 56% of surgeons would recommend a preoperative pain consultation. Most surgeons and anesthesiologists believed in the efficacy of regional anesthetics. However, 43% of surgeons would not advocate for a regional block, perhaps due to their perception of the added perioperative time. Multimodal analgesics were widely accepted by both surgeons and anesthesiologists.

CONCLUSIONS

There is an urgent need to reinforce the importance of patient-centered care, with a specific focus on addressing knowledge gaps and improving perceptions for all the members of the team, including surgeons, anesthesiologists, and perioperative nursing teams, if optimal outcomes are to be achieved for our patients.

摘要

目的

围手术期阿片类药物耐受患者的疼痛管理具有挑战性。尽管区域麻醉和多模式镇痛可能有益,但这些方法往往未被充分利用。目前尚不清楚围手术期疼痛管理的实践模式是否取决于外科医生和麻醉师的知识、态度和信念。

设计

描述性调查。

方法

我们使用 Qualtrics 调查工具,向随机选择的 25 名外科医生和 25 名麻醉师询问了他们在阿片类药物耐受患者的疼痛管理方面的知识、态度、信念和实践情况。

发现

25 名麻醉师中有 23 名和 25 名外科医生中的 18 名回复了调查。两组的人口统计学特征相似。大多数参与的外科医生和麻醉师认为,在阿片类药物耐受患者中,疼痛管理可能具有挑战性。然而,只有 56%的外科医生会建议进行术前疼痛咨询。大多数外科医生和麻醉师都相信区域麻醉的疗效。然而,由于他们认为围手术期时间会增加,43%的外科医生不会提倡使用区域阻滞。多模式镇痛被外科医生和麻醉师广泛接受。

结论

如果要为我们的患者实现最佳治疗效果,就迫切需要加强以患者为中心的护理的重要性,特别要关注解决团队所有成员(包括外科医生、麻醉师和围手术期护理团队)的知识差距和改善他们的认知。

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