在接受镇静治疗的患者中使用疼痛感知指数进行疼痛评估:系统性审查和元分析
Min Kyoung Kim1, Oh Haeng Lee1, Geun Joo Choi1
1Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Korea.
The Korean journal of pain
|June 26, 2025
概括
止痛感知指数 (ANI) 适度检测镇静患者的疼痛,并减少阿片类药物的使用. 研究的高度异质性需要对这些关于疼痛管理的发现进行谨慎的解释.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 关键护理医学 关键护理医学
背景情况:
- 镇静患者的手术内和手术过程中的疼痛很难评估.
- 止痛感知指数 (ANI) 是客观疼痛监测的一个潜在工具.
研究的目的:
- 系统地审查和元分析NI的诊断准确性,以检测镇静患者的疼痛.
- 评估ANI引导止痛和影响阿片类药物消费的能力.
主要方法:
- 在多个数据库 (Cochrane,MEDLINE,Embase,Google Scholar) 中进行系统的文献搜索.
- 对诊断准确度 (灵敏度,特异性,DOR) 和与疼痛量表相关性的元分析.
- 评估ANI对疼痛的反应以及指导与对照组对阿片类药物消费的影响.
主要成果:
- 在疼痛检测方面,ANI表现出中度的诊断准确性 (灵敏度为0.746,特异性为0.776).
- 与非疼痛状态相比,疼痛状态中的ANI显著较低 (SMD-1.140).
- ANI引导的止痛疗法显著降低了阿片类药物消费 (SMD -0.410),异质性较低 (I2=0.0%).
结论:
- 在被镇静的患者中,ANI有效地将疼痛与非疼痛状态区分开来,准确度中等.
- 通过ANI引导的止痛疗法可以减少阿片类药物需求.
- 一些结果的高度异质性要求谨慎地解释ANI的实用性.
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