ObjectiveTo explore the role of fast-track surgery (FTS) in day-case laparoscopic cholecystectomy (DLC) pain management.
MethodsWe used bidirectional cohort study to investigate the patients undergoing day surgery of laparoscopic cholecystectomy admitted into our department. A total of 143 patients between April and September 2014 receiving routine pain management were chosen to be the control group, and 78 patients between October 2014 and January 2015 receiving FTS pain management were regarded as the FTS group. Postoperative pain, early ambulation, influence of pain on the sleep, patients' satisfaction and prolonged hospital stay rate were compared between the two groups.
ResultsPain scores of patients in the FTS group 0-0.5, 0.5-6, 6-12, and 12-24 hours after surgery were significantly lower than those in the control group (P<0.05). The proportion of patients with early postoperative ambulation and patients' satisfaction rate in the FTS group were significantly higher than the control group (P<0.05).
ConclusionThe FTS pain management model can effectively reduce patients' pain after DLC, accelerate patients' postoperative rehabilitation and increase patients' satisfaction.
By reviewing the current status of chronic pain and combining with the new definition of pain revised by the International Association for the Study of Pain in 2020, firstly a prevention-based approach, self-management of pain, and multidisciplinary collaboration based on the integration of bio-psycho-social-environmental factors is proposed. The medical mode will greatly improve the treatment effect of chronic pain and the quality of life of patients. Secondly, the importance of strengthening humanistic care and paying attention to health education, as well as improving medical staff’s awareness of chronic pain and the level of diagnosis and treatment are pointed out. Finally, it is clarified that innovative non-drug treatments and the establishment of digital pain management platforms are the future of chronic pain.
Objective
To explore the effect of pain management by anesthesia nurses on labor analgesia.
Methods
A total of 100 parturient women in the Affiliated Hospital of North China University of Science and Technology between July and August 2015 were randomly divided into two groups: analgesia group and control group with 50 in each. Both two groups accepted labor analgesia routine maternity nursing. Analgesia group accepted maternal perinatal term pain management in addition to the routine nursing. Then we compared degree of pain during the production process, labor time and perineal injury between the two groups of women.
Results
The number of women with a labor pain degree of 0-Ⅲ in the analgesia group was respectively 36 (72%), 12 (24%), 2 (4%) and 0 (0%), and the number in the control group was respectively 23 (46%), 17 (34%), 8 (16%), and 2 (4%). The above difference between the two groups was statistically significant (Z=–2.908, P =0.004). The number of women with intact perineum, perineal injury of lateral and median cut, and Ⅰ-Ⅲ degree laceration in the analgesia group was respectively 31 (62%), 7 (14%), 8 (16%), 4 (8%) and 0 (0%); and the number in the control group was respectively 21 (42%), 12 (24%), 10 (20%), 7 (14%) and 0 (0%), also with significant difference between the two groups (Z =–2.028, P =0.043). The first and second labor stage of the analgesia group was (462.32±101.27) and (63.58±10.38) minutes, and was (568.27±113.28) and (76.92±11.24) minutes in the control group, with significant differences between the two groups (P<0.001). There was no statistically significant difference between the two groups in the third labor stage (5.78±3.02) and (5.97±2.96) minutes, (P=0.654).
Conclusions
The implementation of pain management by anesthesia nurses on labor analgesia can significantly reduce maternal labor pain, shorten the time of labor, and the condition of the perineal injury is mild and easily acceptable. It is worthy of clinical promotion.
ObjectiveTo explore the effect of lidocaine on postoperative pain management after throat surgery.
MethodsSixty patients undergoing throat surgery between June 2011 and May 2013 were randomly divided into trial group and control group, with 30 in each group. Patients in the trial group accepted lidocaine for pain management, while the control group used dicaine. Pain management effect was observed and compared between the two groups.
ResultsThe pain scores of patients at hour 0.5, 2.0, 6.0, and 24.0 after surgery were 2.7±0.8, 2.2±0.9, 1.7±0.8, and 1.5±0.3 in the trial group, and 4.7±1.1, 4.2±0.8, 3.4±0.7, and 2.9±0.5 in the control group, and the differences were significant (P<0.05). Postoperative incidences 6.7% in the trial group, and 30.0% in the control group, and the difference was also significant (P<0.05).
ConclusionLidocaine can reduce the pain of patients in postoperative pain management after throat surgery, with such advantages as long-time functioning, no toxic side effect, and obvious effect, which is worth promoting.
ObjectiveTo investigate the effectiveness of preemptive analgesia with imrecoxib on analgesia after anterior cruciate ligament (ACL) reconstruction. MethodsA total of 160 patients with ACL injuries who met the selection criteria and were admitted between November 2020 and August 2021 were selected and divided into 4 groups according to the random number table method (n=40). Group A began to take imrecoxib 3 days before operation (100 mg/time, 2 times/day); group B began to take imrecoxib 1 day before operation (100 mg/time, 2 times/day); group C took 200 mg of imrecoxib 2 hours before operation (5 mL of water); and group D did not take any analgesic drugs before operation. There was no significant difference in gender, age, body mass index, constituent ratio of meniscal injuries with preoperative MRI grade 3, constituent ratio of cartilage injury Outerbridge grade 3, and visual analogue scale (VAS) score at the time of injury and at rest among 4 groups (P>0.05). The operation time, hospitalization stay, constituent ratio of perioperative American Society of Anesthesiologists (ASA) grade 1, postoperative opioid dosage, and complications were recorded. The VAS scores were used to evaluate the degree of knee joint pain, including resting VAS scores before operation and at 6, 24, 48 hours, and 1, 3, 6, and 12 months after operation, and walking, knee flexion, and night VAS scores at 1, 3, 6, and 12 months after operation. The knee injury and osteoarthritis score (KOOS) was used to evaluate postoperative quality of life and knee-related symptoms of patients, mainly including pain, symptoms, daily activities, sports and entertainment functions, knee-related quality of life (QOL); and the Lysholm score was used to evaluate knee joint function. ResultsAll patients were followed up 1 year. There was no significant difference in operation time, hospitalization time, or constituent ratio of perioperative ASA grade 1 among 4 groups (P>0.05); the dosage of opioids in groups A-C was significantly less than that in group D (P<0.05). Except for 1 case of postoperative fever in group B, no complications such as joint infection, deep vein thrombosis of the lower extremities, or knee joint instability occurred in each group. The resting VAS scores of groups A-C at 6 and 24 hours after operation were lower than those of group D, and the score of group A at 6 hours after operation was lower than those of group C, and the differences were significant (P<0.05). At 1 month after operation, the knee flexion VAS scores of groups A-C were lower than those of group D, the walking VAS scores of groups A and B were lower than those of groups C and D, the differences were significant (P<0.05). At 1 month after operation, the KOOS pain scores in groups A-C were higher than those in group D, there was significant difference between groups A, B and group D (P<0.05); the KOOS QOL scores in groups A-C were higher than that in group D, all showing significant differences (P<0.05), but there was no significant difference between groups A-C (P>0.05). There was no significant difference in VAS scores and KOOS scores between the groups at other time points (P>0.05). And there was no significant difference in Lysholm scores between the groups at 1, 3, 6, and 12 months after operation (P>0.05). ConclusionCompared with the traditional analgesic scheme, applying the concept of preemptive analgesia with imrecoxib to manage the perioperative pain of ACL reconstruction can effectively reduce the early postoperative pain, reduce the dosage of opioids, and promote the early recovery of limb function.
Objective To investigate the effects of pain specialist nurse training (PSNT) on nurse’s pain management knowledge and attitude. Methods By distributing the “questionnaire of pain management knowledge and attitude”, 95 certified nurses, who were from 24 hospitals of different levels in Sichuan, Chongqing, Yunnan and Xinjiang, were investigated to survey their knowledge and attitude changes before and after PSNT. The data were analyzed by t-test. Results A total of 190 questionnaires were distributed to 95 nurses, and 190 returned, with a effective response rate of 100%. The result showed that, the total score after training (34.00±5.30) was significantly higher than that before training (17.58±4.00), with a significant difference (P=0.000). Conclusion The pain specialist nurse training can improve nurses’ knowledge and their attitudes on pain management.
ObjectiveTo summarize the progress of perioperative pain management in patients with lower limb vascular diseases. MethodRetrieved the literature about pain management in patients with lower limb vascular diseases both at home and abroad in recent years and reviewed the literature. ResultsLower limb vascular diseases were very common in elderly patients. Whether it was limb ischemic pain or surgery-related pain, it often increased the stress response and activation of the autonomic system, which was not conducive to the recovery of the disease. Good analgesic management was important for these patients. Perioperative pain management could be performed by intravenous analgesics, oral analgesics, local anesthesia, neuraxial anesthesia and peripheral nerve block. Acute and chronic pain should be actively managed during perioperative period. Pre-emptive analgesic strategies could be implemented in patients with severe peripheral vascular disease. ConclusionsGood perioperative analgesia management is necessary. Pain management which employes one or more analgesic methods is important in maximizing pain relief, function, and quality of life for this patient group.
ObjectiveTo review the advances in perioperative pain management of pediatric and adolescent spinal deformity corrective surgery.MethodsRegular analgesics, drug administrations, and analgesic regimens were reviewed and summarized by consulting domestic and overseas related literatures about perioperative pain management of pediatric and adolescent spinal deformity corrective surgery in recent years.ResultsAs for perioperative analgesis regimens of pediatric and adolescent spinal deformity corrective surgery, regular analgesics include non-steroidal anti-inflammatory drugs, opioids, antiepileptic drugs, adrenergic agonists, and local anesthetic, etc. Besides drug administration by mouth, intravenous injection, and intramuscular injection, the administration also includes patient controlled analgesia, epidural injection, and intrathecal injection. Multimodal analgesia is the most important regimen currently.ConclusionHeretofore, a number of perioperative pain managements of pediatric and adolescent spinal deformity corrective surgery have been applied clinically, but the ideal regimen has not been developed. To design a safe and effective analgesic regimen needs further investigations.
