催眠治疗重症监护室的意外手术疼痛:HYPIC随机临床试验
Adel Maamar1, Claude Faleur2, Kristell Pedrono3
1Service des Médecine intensive - Réanimation, Univ Rennes, CHU Rennes, Rennes, F-35000, France. adel.maamar@chu-rennes.fr.
Critical care (London, England)
|July 18, 2025
概括
催眠并没有显著减少危急病患者在非计划性手术期间的疼痛. 然而,它有效地降低了焦虑水平,并减少了医疗保健提供者的压力.
科学领域:
- 关键护理医学 关键护理医学
- 心理干预 心理干预
- 疼痛管理 疼痛管理
背景情况:
- 危急病患者在无计划的侵入性手术中经常经历疼痛和焦虑.
- 在这种人群中,药理性止痛可能不足或禁用.
- 在这种特定情况下,催眠的证据是有限的.
研究的目的:
- 评估催眠在减轻危急病患者进行非计划性侵入性手术的疼痛和焦虑方面的疗效.
- 为了比较催眠加标准护理与单独标准护理.
主要方法:
- 一项随机,单盲,多中心临床试验 (HYPIC试验) 在法国两个重症监护病房进行.
- 78名患者被随机分配,接受催眠加标准护理或标准护理.
- 主要终点是手术期间的疼痛水平;次要结果包括焦虑,利多卡因消耗和护士压力.
主要成果:
- 在催眠和标准护理组之间没有观察到疼痛水平的显著差异 (2.2 ± 2.9对2.2 ± 3).
- 催眠显著降低了焦虑水平 (2.4 ± 2.8 对比4.1 ± 3;p=0.01) 和ICU护士的压力 (0.1 ± 0.4 对比0.9 ± 1.5;p=0.003).
- 催眠组的患者不太可能需要增加利多卡因 (OR 0.3;p=0.02).
结论:
- 催眠并没有显著减少危急病患者在无计划的侵入性手术期间的疼痛.
- 催眠在减少患者焦虑和医疗保健提供者的压力方面显示出显著的益处.
- 进一步的研究可能会探索催眠在重症监护机构的舒适性和压力减轻.
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