术后疼痛患者的年龄差异及其与并发症的关系:多变量逻辑回归分析
Lisiane Pruinelli1, Michelle A Mathiason2, Sisi Ma3
1Associate professor at the College of Nursing and College of Medicine, University of Florida, Gainesville, Florida.
AANA journal
|October 7, 2025
概括
与年轻患者相比,老年人 (≥65岁) 在腹部手术后经历的急性术后疼痛显著减少. 这一发现凸显了针对年龄特定的疼痛管理策略的必要性.
科学领域:
- 麻醉学 麻醉学
- 老年学是一门学科.
- 疼痛医学 医学 疼痛医学
背景情况:
- 急性手术后疼痛是接受腹部手术的患者的一个重要问题.
- 年龄是影响术后期疼痛感知和报告的潜在因素.
- 了解与年龄相关的疼痛差异对于有效的疼痛管理至关重要.
研究的目的:
- 调查患者年龄与严重急性术后疼痛发生率之间的关联.
- 为了确定与腹部手术后严重疼痛相关的人口和临床因素.
- 为护士麻醉师提供特定年龄的疼痛管理策略.
主要方法:
- 对2600名接受腹部手术的成年患者进行了回顾性分析.
- 患者分为三个年龄组:18-44岁,45-64岁和65岁以上.
- 统计分析包括奇平方测试和多变量逻辑回归来评估疼痛严重程度 (数值评分尺度≥7) 和相关因素.
主要成果:
- 与年龄≥65岁的患者相比,与年轻的成年人 (18-44岁) 相比,患者报告严重的手术后疼痛的可能性明显较低 (OR,0.48;CI,0.39-0.60).
- 中年患者 (45-64岁) 也显示严重疼痛的可能性降低 (OR,0.77;CI,0.63-0.91).
- 与严重疼痛增加的可能性相关的因素包括女性性别,慢性疼痛史和抑郁症/焦虑症的存在.
结论:
- 老年人 (≥65岁) 在经历重大腹部手术后明显不太可能出现严重的急性术后疼痛.
- 女性性别,慢性疼痛史和心理伴随性疾病增加了严重术后疼痛的风险.
- 对特定年龄的疼痛模式的认识可以引导护士麻醉师优化术后疼痛管理并改善患者的治疗结果.
更多相关视频
07:14A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery
Published on: January 18, 2018
9.8K
06:55Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
15.0K
相关概念视频
01:23Peripheral Artery Disease V: Postoperative Nursing Management
376
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
376
01:20Comparing the Survival Analysis of Two or More Groups
553
Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
553
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
285
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
285
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
187
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
187
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
227
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
227
01:25Analgesia and Pain Management
1.5K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.5K