儿童尾切除术患者疼痛控制的冷疗法:一项随机对照试验
P Nina Scalise1, Donna C Koo1, Jonathan M Durgin1
1Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, United States.
Journal of pediatric surgery
|April 3, 2024
概括
寒冷治疗没有显著减少尾切除术后儿童的疼痛或麻醉剂使用. 然而,大多数患者发现它在主观上对疼痛管理有帮助.
科学领域:
- 儿科手术 儿科手术
- 疼痛管理 疼痛管理
- 术后护理 术后护理
背景情况:
- 局部冰疗对于疼痛和阿片类药物减轻腹部切口的成年人是有效的.
- 在腹腔镜尾切除术后,其在儿科患者群体中的有效性需要进一步研究.
研究的目的:
- 为了评估冷治疗系统在腹腔镜尾切除术后儿童的疼痛管理中的有效性.
- 评估冷疗对术后疼痛评分,麻醉剂消耗和患者满意度的影响.
主要方法:
- 进行了一项随机对照试验 (I级证据),58名7岁以上的患者接受了腹腔镜尾切除术.
- 患者被随机分配,接受标准疼痛治疗或标准护理以及配有凉爽腹部的冷热治疗系统.
- 疼痛评分,麻醉剂使用和患者满意度在术后的前三天被分析.
主要成果:
- 寒冷治疗和对照组之间没有观察到中位数疼痛得分或麻醉剂消费的显著差异.
- 大多数接受寒冷治疗的患者报告主观疼痛改善:71%的POD1,74%的POD2和50%的POD3.
- 患者满意度调查的响应率很高,在对照组中为74%,在治疗组中为89%.
结论:
- 寒冷疗法可以作为儿童尾切除患者疼痛控制的有益辅助.
- 对客观疼痛评分或麻醉剂使用的显著减少的缺乏可能归因于这一儿科队列的快速恢复和低基线止痛需求.
- 进一步的研究可以探索儿童手术患者冷疗法应用的最佳方案.
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