在重症监护室入院后的疼痛和精神病理学
Nour Smaisim1, Mienke Rijsdijk1, Yuri van der Does2,3
1Pain Clinic, Department of Anaesthesiology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
Anaesthesia and intensive care
|June 16, 2024
概括
进入重症监护室 (ICU) 之前和之后的疼痛与幸存者的精神病理有关. 在ICU停留期间疼痛管理不良也会增加风险,强调需要更好的疼痛护理.
科学领域:
- 关键护理医学 关键护理医学
- 精神病学是一个精神病学.
- 疼痛医学 医学 疼痛医学
背景情况:
- 心理病理影响了55%的患者在一年后入住重症监护室 (ICU).
- 在ICU幸存者的疼痛和精神病理之间的关系还不太清楚.
- 慢性疼痛和精神病理在一般人群中具有已知的双向关系.
研究的目的:
- 调查ICU入院前,期间和之后经历的疼痛与ICU幸存者的精神病理发展之间的关联.
- 在重症监护后的个体中识别心理病理的风险因素.
- 探索疼痛管理经验对长期心理健康结果的影响.
主要方法:
- 从2013年到2016年,在荷兰的混合ICU中进行了一项队列研究.
- 1105名ICU幸存者在1年的随访期间使用验证的疼痛,焦虑,抑郁和PTSD问卷进行了评估.
- 使用多变量逻辑回归分析来确定疼痛变量与精神病理学之间的关联.
主要成果:
- 50%的ICU幸存者在1年的随访中经历了精神病理.
- 在ICU入院前 (OR 1.18) 和ICU出院后 (OR 2.38) 经历的疼痛与精神病理学有显著的关联.
- 虽然ICU停留期间的疼痛没有关联,但对疼痛管理不足的记忆是 (OR 2.19).
结论:
- 在ICU入院前后的疼痛暴露是长期精神病理学的重要预测因素.
- 在ICU停留期间不充分的疼痛管理与发展精神病理的风险增加有关.
- 针对ICU幸存者的疼痛评估和管理可能有助于早期识别和预防心理健康问题.
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