镇静反应程度评估法在患者自控镇痛疗法呼吸抑制监测中的应用  

Monitoring level of sedation to prevent from respiratory depression during patient controlled analgesia therapy

作　　者：童莺歌[1] 叶志弘[2] 田素明[1] 王宏伟[1] 钟泰迪[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院麻醉科,杭州市310016 [2]浙江大学医学院附属邵逸夫医院护理部,杭州市310016

出　　处：《中华护理杂志》2010年第11期969-971,共3页Chinese Journal of Nursing

基　　金：浙江省卫生厅科研基金项目资助(编号:2009A112)

摘　　要：目的探讨镇静反应程度(Level of Sedation,LOS)评估法在监测患者自控镇痛疗法(Patient Controlled Analgesia,PCA)中过度镇静和呼吸抑制发生的成效。方法引进澳大利亚LOS评估法,建立评估规程,护士按照规程对3690例PCA疗法患者持续规律地进行LOS评估,并按照规程对异常情况进行处理。此外,对护士开展LOS评估规程应用体会的问卷调查。结果 22例LOS2或LOS3患者经及时处理,均转为LOS0或LOS1。护士认为LOS评估法简单易用,并对安全护理实践具有积极指导意义。结论 LOS评估法有助于及时发现PCA疗法中过度镇静和呼吸抑制的发生,提高PCA疗法的安全性。Objective To evaluate the effect of monitoring level of sedation（LOS） on the prevention of over-sedation and respiratory depression during patient controlled analgesia （PCA） therapy.Methods Nursing procedure of LOS monitoring was built following the standard of Victorian Quality Council.Nurses monitored LOS for 3690 patients receiving PCA therapy and dealt with unstable cases according to the nursing procedure.Moreover,nurses＇ experience related to monitoring LOS was investigated by a self-designed questionnaire.Results After timely intervention,22 unstable cases with LOS 2 or LOS 3 recovered well.Most of the nurses thought LOS monitoring was easy to use and provided them useful information to enhance patient safety.Conclusion Monitoring level of sedation can help nurses to detect over-sedation and respiratory depression early and enhances patient safety during PCA therapy.

关 键 词：镇痛药 阿片类 清醒镇静 镇痛 病人控制 通气不足 

分 类 号：R614[医药卫生—麻醉学]