椎管内麻醉体位摆放抱枕临床效果的评价  

Evaluation of clinical effect of position pillows for neuraxial anesthesia

作　　者：张静[1] 王洁初 朱欣艳 张小青[1] 王冬[3] 于雪瑶 霍金金 丛竹凯 刘怡 刘炜[1] 郝立圆 樊丽 李潇潇[4] Zhang Jing;Wang Jiechu;Zhu Xinyan;Zhang Xiaoqing;Wang Dong;Yu Xueyao;Huo Jinjin;Cong Zhukai;Liu Yi;Liu Wei;Hao Liyuan;Fan Li;Li Xiaoxiao(Department of Anesthesiology,Peking University Third Hospital,Beijing 100191,China;Department of Anesthesiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Medical Engineering,Peking University Third Hospital,Beijing 100191,China;Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院麻醉科,北京100191 [2]首都医科大学附属北京友谊医院麻醉科,北京100050 [3]北京大学第三医院医学工程处,北京100191 [4]北京大学第三医院药学部,北京100191

出　　处：《中华麻醉学杂志》2024年第9期1135-1138,共4页Chinese Journal of Anesthesiology

基　　金：北京大学第三医院护理创新转化基金(BYSYHLZH2022011);北京大学医学青年科技创新平台发展基金(BMU2022PYB011)。

摘　　要：目的:评价椎管内麻醉体位摆放抱枕的临床效果。方法:本研究为前瞻性、随机、对照研究。选择2023年2月至10月于北京大学第三医院椎管内麻醉下行择期手术的患者412例,年龄≥18岁,ASA分级Ⅰ-Ⅲ级,采用随机数字表法分为2组(n=206):抱枕组(P组)和对照组(C组)。C组按常规流程进行椎管内麻醉体位摆放。P组患者在常规麻醉前口头宣教基础上,使用体位抱枕进行体位摆放。记录1次穿刺成功情况、穿刺时间、体位摆放时间。记录穿刺过程中再次调整体位、体动、异感发生情况。于体位摆放前、体位摆放后及麻醉后,采用VAS评分评价患者焦虑程度。于麻醉操作完成后,采用VAS评分评价患者舒适度和操作医生对体位摆放满意度。结果:与C组比较,P组体位摆放时间缩短,体位摆放后和麻醉后焦虑程度下降,焦虑改善率提高,患者舒适度评分及操作医生对体位摆放满意度评分升高(P<0.05),1次穿刺成功率、穿刺时间、穿刺过程体动及调整体位发生率差异无统计学意义(P>0.05)。穿刺过程2组均未见异感发生。结论:椎管内麻醉体位摆放抱枕不仅可优化体位摆放的效果,还可提高患者舒适度。ObjectiveTo evaluate the clinical effect of the position pillows for neuraxial anesthesia.MethodsThis was a prospective randomized controlled trial.Four hundred and twelve patients regardless of gender,aged≥18 yr,of American Society of Anesthesiologists Physical Status classificationⅠ-Ⅲ,who underwent elective surgery under neuraxial anesthesia at Peking University Third Hospital from February to October 2023,were selected and divided into 2 groups(n=206 each)using a random number table method:pillow group(P group)and control group(C group).Group C underwent the conventional procedure for neuraxial anesthesia.The patients were placed in a position using the position pillow on the basis of oral education before routine anesthesia in group P.The success rate of puncture at first attempt,puncture time and position placement time were recorded.The adjustment of position,body movement and occurrence of discomfort during the puncture were also recorded.The visual analogue scale score was used to evaluate the level of anxiety before positioning,after positioning and after anesthesia.The visual analogue scale score was used to evaluate the patient′s comfort and the operator′s satisfaction with position after the anesthesia was completed.ResultsCompared with group C,the time for positioning was significantly shortened,the anxiety level was decreased after positioning and after anesthesia,the rate of improvement in anxiety was increased,the scores for the patient′s comfort and the operator′s satisfaction with position were increased(P<0.05),and no significant changes were found in the success rate of puncture at first attempt,puncture time and incidence of body movement during the puncture and incidence of the adjustment of position(P>0.05).No discomfort was observed in either group during the puncture.ConclusionsThis new type of position pillows for the neuraxial anesthesia can not only optimize the effect of position placement,but also improve the patients′comfort.

关 键 词：麻醉 硬膜外 麻醉 脊椎 体位 

分 类 号：R614[医药卫生—麻醉学]