エル・エマラティ病院での出産時の痛み管理:臨床検査
Reem Y Dabbour1, Tayseer A Hassan1, Maha S Faqawi1
1The Islamic University in Gaza, Gaza City, Gaza Strip, occupied Palestinian territory.
Lancet (London, England)
|March 20, 2018
まとめ
ガザでの出産の痛み管理は 薬剤の選択肢が限られており 地域麻酔は提供されていません 患者の選択と痛み緩和に関する議論も不十分で,National Institute for Health and Care Excellenceのガイドラインには合わなかった.
科学分野:
- 産婦人科
- 痛みの管理
- 公衆衛生
背景:
- ガザ地区のラファにあるエル・エマラティ病院で 産痛管理の実践を評価しています
- NICEのガイドラインと現在の実践を比較する.
研究 の 目的:
- 出産中の女性に提供される 痛みを和らげる選択肢の適切さを評価する.
- 既存の痛み管理プロトコルと確立された国際基準の間の不一致を特定する.
主な方法:
- 2016年2月1日から4月1日の間に連続した50人の出産患者のサンプル採取.
- NICEのガイドラインに基づく監査シートを用いてデータ収集
- 非薬理学的方法 (呼吸,リラックス,マッサージ) と薬理学的介入を含む.
主要な成果:
- すべての患者は非薬物療法による疼痛管理 (呼吸/リラックステクニック; 100%,腹部マッサージ; 70%) を受けました.
- 薬理学的な痛み緩和は患者の40%に投与された.
- 患者には薬の副作用の報告も地域麻酔の提供も行われませんでした.
結論:
- 出産時の痛みの管理に重大な欠陥があり,利用可能な技術が十分に活用されていない.
- 患者の情報が限られ,痛み緩和の選択肢がないことが判明した.
- 実践は,分娩の痛み経験と患者の好みを主観的かつ個別的に反映する必要があります.
関連する概念動画
Hospitals-II
1.2K
Hospitals provide inpatient and outpatient services. Inpatient services provide care to patients that stay in the hospital for an extended period, ranging from days to months. Examples of inpatient services include intensive care units, hospital wards, or surgeries. Outpatient services provide care to patients who come to a hospital for a diagnostic or treatment but do not stay overnight —for example, diagnostic tests, surgical procedures, or health education.
Nurses that work in...
Nurses that work in...
1.2K
Analgesia and Pain Management
1.9K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.9K
Hospitals-I
1.7K
Hospitals offer medical and surgical care to the sick and injured, along with accommodation while they recover. At the same time, they also provide outpatient, emergency, psychiatric, and rehabilitation services to meet various community needs. In addition to providing medical care, hospitals also act as hubs for medical research and training. Hospitals use clinical procedures and evidence-based practice standards to deliver patient care. To deliver safe and efficient care, a nurse must stay up...
1.7K
Esophageal Perforation-II: Clinical Manifestations and Management
746
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
746
Barrett Esophagus-II: Clinical Manifestations and Management
1.1K
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
1.1K
Esophageal Varices-II: Clinical Features and Management
605
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
605


