一个有前景的纵向质量倡议,以改善剖腹产途径后的增强恢复
Liviu Cojocaru1, Suzanne Alton2, Autusa Pahlavan3
1Department of Obstetrics, Gynecology and Reproductive Science, Division of Maternal-Fetal Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
American journal of perinatology
|September 25, 2023
概括
剖腹产 (ERAC) 途径后改善康复显著降低了住院和门诊阿片类药物使用和疼痛评分. 此外,ERAC还改善了剖腹产患者的术后康复指标.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 剖腹产 (CD) 是一种常见的外科手术程序.
- 手术后的疼痛和阿片类药物的使用对于接受CD的患者来说是很大的担忧.
- 手术后增强恢复 (ERAS) 协议旨在优化患者的康复并减少并发症.
研究的目的:
- 评估剖腹产后增强康复 (ERAC) 途径对阿片类药物消费和术后康复的影响.
- 为了比较住院和门诊阿片类药物使用,疼痛评分,以及ERAC实施前后的恢复指标.
主要方法:
- 进行了一项前性的纵向质量改进研究.
- 接受无并发性CD的患者被分为ERAC前和ERAC后的队列.
- 测量结果包括住院和门诊阿片类药物使用 (MME),疼痛得分,食时间,行走和医院出院.
主要成果:
- 在ERAC后的队列中,术后阿片类药物需求率显著降低 (64.3%与81.6%相比),每次住院MME使用率降低 (16.8与30MME相比).
- 出院时的阿片类药物处方减少了,在ERAC后组 (2.2对3.3) 中,三角形疼痛得分明显较低.
- 术后恢复的指标,包括食和行走的时间,在ERAC后队列中表现出改善.
结论:
- 在剖腹产后,ERAC途径有效减少住院和门诊阿片类药物使用.
- 实施ERAC途径导致患者报告疼痛得分降低.
- 采用以患者为中心的方法可以增强ERAC途径的积极结果.
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