无线镇痛系统应用于胸腔镜肺切除术后疼痛管理的回顾性大样本队列研究  

Application of wireless analgesic system in pain management after thoracoscopic lung resection:A retrospective cohort study with large sample

作　　者：郭嘉琪 苗青 张芸芸 张晓峰[1] 陈旭[1] 吴镜湘 GUO Jiaqi;MIAO Qing;ZHANG Yunyun;ZHANG Xiaofeng;CHEN Xu;WU Jingxiang(Department of Anesthesiology,Shanghai Chest Hospital,Shanghai Jiao Tong University,School of Medicine,Shanghai,200030,P.R.China)

机构地区：[1]上海市胸科医院/上海交通大学医学院附属胸科医院麻醉科,上海200030

出　　处：《中国胸心血管外科临床杂志》2023年第6期873-878,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：上海市申康医院发展中心临床研究三年行动计划重点课题(SHDC2020CR4063)。

摘　　要：目的探讨无线镇痛系统与传统镇痛系统应用于胸腔镜肺切除手术后疼痛管理的效果。方法回顾性纳入2016年6月—2021年6月于上海市胸科医院全身麻醉下实施胸腔镜肺切除手术并使用自控静脉镇痛的患者。按照镇痛泵不同类型,将患者分为无线镇痛泵组(可在中央站远程记录镇痛泵运行数据)和传统镇痛泵组。获取麻醉信息系统中记录的疼痛数字评分(numerical rating scale,NRS)和术后恶心呕吐(postoperative nausea and vomiting,PONV)评分。比较两组术后48 h内镇痛不全(NRS≥4分)发生率、术后24 h内PONV发生率、48 h镇痛泵输注完成率。结果纳入59431例患者,其中男24855例、女34576例,年龄18~75岁。无线镇痛泵组17209例,传统镇痛泵组42222例。无线镇痛泵组的术后48 h内镇痛不全发生率(3.75%vs.4.98%,P=0.007)、术后24 h内PONV发生率低于传统镇痛泵组(13.60%vs.16.70%,P=0.030),镇痛泵48 h输注完成率高于传统镇痛泵组(83.40%vs.71.90%,P<0.001)。无线镇痛泵组可监控镇痛泵按压次数及使用情况,传统镇痛泵组则无法记录相关数据。结论和传统镇痛泵相比,无线镇痛管理系统可能效果更好,可控性更强,便于及时、精准、个体化管理,不良反应发生率低,可能更适用于围术期镇痛管理。Objective To investigate the effect of intravenous analgesia with a wireless or traditional analgesia pump system in thoracoscopic lung resection.Methods Patients who used the patient-controlled intravenous analgesia after thoracoscopic lung resection between June 2016 and June 2021 were enrolled in the study.They were allocated into a wireless pump group(a ZigBee-based wireless analgesia pump system collecting data automatically)and a traditional analgesia pump group.Perioperative analgesia management followed the routine standard operation protocol of Shanghai Chest Hospital.The patients’numeric rating scale(NRS)for pain and postoperative nausea and vomiting(PONV)scores were collected for analysis from the Anesthesia Information Record System.The incidence of postoperative analgesia insufficiency(defined as NRS≥4 points)within 48 h,the incidence of PONV within 24 h,and the 48 h completion rate of analgesia pump infusion were compared.Results A total of 59431 patients were collected,including 24855 males and 34576 females,17209 patients in the wireless pump group,and 42222 patients in the traditional analgesia pump group.The incidence of analgesia insufficiency within 48 h after operation(3.75%vs.4.98%,P=0.007),the incidence of PONV within 24 h after operation(13.60%vs.16.70%,P=0.030)in the wireless pump group were lower than those in the traditional analgesia pump group.The 48 h completion rate of analgesia pump infusion in the wireless pump group was higher than that in the traditional analgesia pump group(83.40%vs.71.90%,P<0.001).The wireless pump group could monitor the pressing times and use of the analgesia pump,while the traditional analgesia pump group could not record the relevant data.Conclusion Compared with the traditional analgesia pump,the wireless analgesia management system may be convenient for timely,accurate and individualized management,and has good analgesic effect and low incidence of adverse reactions,and may be more suitable for perioperative analgesia management.

关 键 词：无线镇痛系统 静脉镇痛管理 术后疼痛管理 

分 类 号：R614[医药卫生—麻醉学]