Application of local cryotherapy in relieving postoperative pain after lumbar spinal fusion
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摘要:
目的 探讨局部冷冻治疗在减轻腰椎融合术术后疼痛中的效果。 方法 选取我院腰椎融合术术后患者150例,随机分为对照组和观察组,每组75例,观察组术后将冰袋置于患者手术部位,20 min后移除,每8 h 1次,至术后48 h为止。对照组不使用冰袋,其余护理及康复锻炼方法均和观察组患者相同。记录两组患者术前及术后1、2、4、8、16、24、36、48 h视觉模拟(VAS)评分,记录术后6、12、24、48 h吗啡用量,在48 h时用李克特量表记录两组患者对于镇痛效果满意度。 结果 观察组术后1、2、4、8、16、24、36、48 h VAS评分均低于对照组(P<0.05)。观察组术后0~6、6~12、12~24和24~48 h吗啡用量及48 h内吗啡总用量均低于对照组(P<0.05)。观察组术后48 h镇痛满意度评分高于对照组(P<0.05)。 结论 局部冷冻治疗可有效减轻腰椎融合术术后患者疼痛,减少阿片类镇痛药物使用,提高患者镇痛满意度,值得临床护理推广。 Abstract:Objective To explore the therapeutic effect of local cryotherapy in relieving postoperative pain after lumbar spinal fusion. Methods 150 patients underwent lumbar spinal fusion were included and randomly divided into control group and experimental group (n=75). In the experimental group, an ice bag was placed at the surgical site of patients and removed after 20 min, which was repeated every 8 h within the postoperative 48 h. Patients in the control group received the same postoperative treatment except cryotherapy. Preoperative and postoperative visual analog scales (VAS) scores at 1, 2, 4, 8, 16, 24, 36 and 48 h were recorded. Meanwhile, postoperative morphine consumption at 6, 12, 24 and 48 h were recorded. Likert scale was used to evaluate patients’ satisfaction with postoperative analgesia at 48 h. Results Postoperative VAS scores in the experimental group at 1, 2, 4, 8, 16, 24, 36 and 48 h were significantly lower than those in the control group (P<0.05). Postoperative morphine consumption between 0 and 6 h, 6 and 12 h, 12 and 24 h, 24 and 48 h, total morphine consumption at 48 h were significantly lower in the experimental group than those in the control group (P<0.05). Likert scale score at postoperative 48 h was significantly higher in the experimental group than that in the control group (P<0.05). Conclusion Local cryotherapy could relieve postoperative pain after lumbar spinal fusion, reduce postoperative consumptions of opioid analgesics and enhance patients’ satisfaction with postoperative analgesia, thus worthy of clinical application and promotion. -
Key words:
- cryotherapy /
- lumbar spinal fusion /
- postoperative pain
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表 1 两组患者一般资料比较
组别 年龄(岁,Mean±SD) 女性[n(%)] 腰痛时间(年,Mean±SD) VAS评分(分,Mean±SD) 对照组 62.3±10.8 33(44.0) 3.8±0.8 6.8±2.1 观察组 62.8 ±11.4 34(45.3) 3.9±1.0 7.0±1.8 表 2 两组患者冷冻治疗前后VAS评分比较(分,n=75,Mean±SD)
组别 治疗前 治疗后1 h 治疗后2 h 治疗后4 h 治疗后8 h 治疗后16 h 治疗后24 h 治疗后36 h 治疗后48 h 对照组 6.8±2.1 4.8±1.6 4.4±1.5 3.9±1.3 3.3±1.3 3.0±1.2 2.7±1.4 2.6±1.3 2.5±1.1 观察组 7.0±1.8 3.7±1.7* 3.4±1.4* 3.0±1.2* 2.4±1.3* 2.2±1.1* 1.9±0.9* 1.8±1.0* 1.8±0.8* *P<0.05vs对照组. 表 3 两组患者不同时间段使用的吗啡用量比较(mg,n=75,Mean±SD)
组别 0~6 h 6~12 h 12~24 h 24~48 h 48 h总量 对照组 0.4±0.5 2.9±2.4 3.4±2.6 2.4±1.8 9.1±4.1 试验组 0.2±0.3* 1.7±1.2* 1.9±1.4* 1.4±0.9* 5.2±2.5* *P<0.05vs对照组. -
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