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加拿大动物健康技术人员对犬猫术后疼痛管理的态度与担忧

Attitudes and concerns of Canadian animal health technologists toward postoperative pain management in dogs and cats.

作者信息

Dohoo S E, Dohoo I R

机构信息

Department of Anatomy and Physiology, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown.

出版信息

Can Vet J. 1998 Aug;39(8):491-6.

Abstract

Three hundred and twenty-two Canadian animal health technologists (AHTs) were surveyed to determine their attitudes toward postoperative pain management in dogs and cats following 6 surgical procedures, their concerns regarding the use of opioid analgesics, and their role within veterinary practices with respect to postoperative pain control. Two hundred and sixty-four (82%) returned the questionnaire. Pain perception was defined as the average of pain rankings for dogs and cats (on a scale of 1 to 10) following abdominal surgery, or the value for dogs or cats if the AHT worked with only 1 of the 2 species. Maximum concern about the risks associated with the postoperative use of morphine or oxymorphone was defined as the highest rating assigned to any of the 6 risks evaluated in either dogs or cats. Animal health technologists reported significantly higher pain perception scores than did veterinarians who completed a similar survey 2 years previously. Higher pain perception scores were associated with decreased satisfaction with the adequacy of analgesic therapy in their practice, higher pain control goals, and attendance at continuing education within the previous 12 months. The majority of AHTs (55%) agreed that one or more risks associated with the use of morphine or oxymorphone outweighed the benefits. The 3 issues that were perceived to pose the greatest risk were respiratory depression, bradycardia, and sedation and excitement, for dogs and cats, respectively. Most AHTs (68%) considered their knowledge related to the recognition and control of pain to be adequate, compared with 24% of veterinarians who responded to a similar previous survey. As for veterinarians, experience gained while in practice was ranked as the most important source of knowledge, while the technical program attended was ranked as least important. Over 88% of the AHTs provided nursing care during the postoperative period, monitored animals for side effects of postoperative analgesic therapy, informed veterinarians when animals were in pain, recommended analgesic therapy when they believed it was warranted, reported that animals received analgesics when they believed it was warranted, administered analgesics under the instruction of a veterinarian, and believed they were part of a team working to provide adequate postoperative pain control.

摘要

对322名加拿大动物健康技术人员(AHT)进行了调查,以确定他们对6种外科手术后犬猫术后疼痛管理的态度、对使用阿片类镇痛药的担忧,以及他们在兽医实践中在术后疼痛控制方面所起的作用。264人(82%)返回了问卷。疼痛感知被定义为犬猫腹部手术后疼痛评分(1至10分)的平均值,如果AHT只处理这两个物种中的一种,则为该物种的评分值。对术后使用吗啡或羟吗啡酮相关风险的最大担忧被定义为在犬或猫中评估的6种风险中任何一种的最高评分。动物健康技术人员报告的疼痛感知评分显著高于两年前完成类似调查的兽医。较高的疼痛感知评分与对其实践中镇痛治疗充分性的满意度降低、更高的疼痛控制目标以及过去12个月内参加继续教育有关。大多数AHT(55%)同意,与使用吗啡或羟吗啡酮相关的一种或多种风险超过了益处。分别被认为对犬猫构成最大风险的3个问题是呼吸抑制、心动过缓以及镇静和兴奋。与之前类似调查中24%做出回应的兽医相比,大多数AHT(68%)认为他们与疼痛识别和控制相关的知识足够。与兽医一样,实践中获得的经验被列为最重要的知识来源,而参加的技术课程被列为最不重要。超过88%的AHT在术后期间提供护理,监测动物术后镇痛治疗的副作用,当动物疼痛时通知兽医,在他们认为有必要时推荐镇痛治疗,报告动物在他们认为有必要时接受了镇痛药,在兽医的指导下给予镇痛药,并认为他们是致力于提供充分术后疼痛控制的团队的一员。

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