Apostle-Mitchell M, MacDonald G
Critical Care Trauma Centre, London Health Sciences Centre, Ontario.
Off J Can Assoc Crit Care Nurs. 1997 Fall;8(3):19-22.
Nursing research suggests that pain in critically ill patients is inadequately controlled and has deleterious effects. The critical care nurse must depend on the patient's perception of pain and its expression in physiological and behavioural responses. Ventilatory support, fluctuating levels of consciousness, hemodynamic instability and severity of illness are often barriers to the expression and interpretation of pain. This article includes a review of the nursing literature pertaining to pain management in the critically ill patient. Existing practices are examined and alternative approaches explored. Therapeutic touch (TT), one innovative approach, is proposed as an adjunct to pharmacological intervention TT is a non-invasive, holistic practice that promotes comfort, relaxation, stress reduction and heating. Clinical studies suggest that TT prolongs the interval between analgesies. The authors highlight the 10-year clinical experience of a critical care nurse practising TT in a 30-bed critical care and trauma centre.
护理研究表明，重症患者的疼痛未得到充分控制，且会产生有害影响。重症护理护士必须依赖患者对疼痛的感知及其在生理和行为反应中的表现。通气支持、意识水平波动、血流动力学不稳定以及疾病的严重程度常常成为疼痛表达和解读的障碍。本文对与重症患者疼痛管理相关的护理文献进行了综述。审视了现有做法并探索了替代方法。一种创新方法——治疗性触摸（TT），被提议作为药物干预的辅助手段。TT是一种非侵入性的整体疗法，可促进舒适、放松、减轻压力并产生温热感。临床研究表明，TT可延长镇痛间隔时间。作者着重介绍了一位重症护理护士在一家拥有30张床位的重症监护和创伤中心运用TT的10年临床经验。
