剖腹产后的疼痛和不良影响:全国范围的前性队列研究
Patricia Duch1, Anne Wikkelsø, Christoffer C Jørgensen
1From the Department of Anaesthesia, Copenhagen University Hospital, North Zealand, Hillerød (PD, CCJ, AKN), Department of Anaesthesia and Intensive Care Medicine, Zealand University Hospital, Roskilde (AW), Department of Clinical Medicine, Copenhagen University, Copenhagen (AW, CCJ, JCJ, OM, AKN), Copenhagen Trial Unit, Centre for Clinical Intervention Research Capital Region of Denmark (JCJ), Department of Anaesthesiology, Zealand University Hospital Køge (OM), Department of Anaesthesia and Intensive care, University Hospital of Southern Denmark, Kolding (HN) and Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (HN).
剖腹产后严重的疼痛和阿片类药物副作用很常见,在24小时内影响超过一半的患者. 这凸显了改善疼痛管理策略的必要性,以增强康复和患者福祉.
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:
- 剖腹产经常导致严重的术后疼痛,使患者复杂的恢复.
- 剖腹产后有效的疼痛管理必须平衡缓解疼痛,尽量减少与阿片类药物相关的不良影响.
研究的目的:
- 为了确定选择性剖腹产后的急性疼痛的发生率和严重程度.
- 描述早期术后期与阿片类药物管理相关的不良反应的发生和类型.
主要方法:
- 一个前性的,全国性的丹麦多中心队列研究.
- 包括所有丹麦分娩医院接受选择性剖腹产的患者.
- 利用基于智能手机的问卷收集患者报告的疼痛 (数值评分表) 和阿片类药物不良反应的结果,在多个时间点,直到分娩后30天.
主要成果:
- 59%的患者在24小时内报告了严重的疼痛 (NRS ≥7),在术后12小时达到顶峰 (NRS 6).
- 55%的患者在24小时内经历了与阿片类药物相关的不良反应,是最常见的.
- 24小时内口服吗啡相当剂 (OME) 的中位数为30毫克,这表明阿片类药物使用量很大.
结论:
- 超过一半的患者在剖腹产后24小时内经历严重疼痛,在12小时内达到峰值强度.
- 大多数患者报告与阿片类药物相关的中度至严重的不良反应,需要优化疼痛管理策略.
- 结果为患者和医疗保健提供者提供有关预期疼痛轨迹和不良事件的关键信息,指导未来的干预和研究.
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