疼痛教育对腹部外科病人疼痛认知度及术后康复的影响

【目的】通过疼痛教育提高腹外科住院病人对术后疼痛及疼痛控制的认知度，改善术后疼痛的质量。【方法】将218例拟施行腹部手术的患者随机分为试验组和对照组各109例。实验组由负责护士在病人入院后一对一实施疼痛教育，教育内容统一（包括疼痛的概念、疼痛的评估方法、疼痛的不良反应、术后常用的镇痛方法及优缺点等）。对照组未予疼痛相关教育。术前进行问卷调查，评估病人对术后疼痛及镇痛的认知度；术后观察比较病人疼痛程度（VAS评分）、镇痛的处理、舒适度及恢复情况（包括首次肛门排气和首次下床时间、24h和48h睡眠时间、住院天数）。【结果】实验组对术后疼痛及疼痛控制的认知明显好于对照组，试验组术后不同镇痛需求明显高于对照组（P〈0．01）、术后24h和48h睡眠时间显著长于对照组（P〈0．01）、首次肛门排气和首次下床时间早于对照组（P〈0．01）、住院天数小于对照组（P〈0．01）。【结论】疼痛教育能显著提高病人对疼痛及疼痛控制的认知度，提高病人术后镇痛的接受程度，改善腹部术后病人的镇痛质量，促进病人早日康复。     

疼痛教育对产科病人疼痛认知及术后康复的影响

[目的]提高住院病人对术后疼痛及疼痛控制的认知,改善术后镇痛质量,促进病人早日康复。[方法]将1088例剖宫产产妇J随机分为实验组和对照组,实验组由责任护士在病人入院后一对一实施疼痛教育,对照组予以常规健康教育。[结果]实验组对术后疼痛及疼痛控制的认知明显优于对照组,两组术后镇痛需求、术后24h和48h睡眠时间、首次肛门排气时间和首次下床时间、住院天数比较差异有统计学意义。[结论]疼痛教育能显著提高病人对疼痛及疼痛控制的认知,改善产科病人术后的镇痛质量,促进病人早日康复。     

疼痛教育对产科病人疼痛认知及术后康复的影响

[目的]提高住院病人对术后疼痛及疼痛控制的认知,改善术后镇痛质量,促进病人早日康复.[方法]将1 088例剖宫产产妇随机分为实验组和对照组,实验组由责任护士在病人入院后一对一实施疼痛教育,对照组予以常规健康教育.[结果]实验组对术后疼痛及疼痛控制的认知明显优于对照组,两组术后镇痛需求、术后24 h和48 h睡眠时间、首次肛门排气时间和首次下床时间、住院天数比较差异有统计学意义.[结论]疼痛教育能显著提高病人对疼痛及疼痛控制的认知,改善产科病人术后的镇痛质量,促进病人早日康复.     

疼痛教育对胃部分切除病人疼痛认知度及术后康复的影响

目的通过疼痛教育,提高住院病人对术后疼痛及疼痛控制的认知度及对术后镇痛的接受程度。方法将136例拟施行胃部分切除手术病人随机分为干预组和对照组,各68例。干预组由责任护士实施一对一疼痛教育,对照组未予疼痛教育。术后观察主动呼叫要求镇痛的例数、镇痛治疗的满意度、术后恢复情况、术后48h内睡眠时间等。结果干预组术后主动呼叫要求镇痛的例数、镇痛满意度均明显高于对照组,术后48h睡眠时间显著长于对照组,首次下床及肛门排气时间早于对照组(P<0.05,P<0.01)。结论疼痛教育能显著提高胃部分切除病人对疼痛控制的认知度,提高病人术后镇痛的接受程度。     

疼痛教育对切腹胆囊摘除术患者术后康复的影响

目的:通过术后疼痛知识的宣教,提高病人对术后疼痛的认识,主动寻求术后镇痛,促进病人早日康复。方法:选择60例切腹单纯胆囊摘除术患者,随机分2组,对照组30例实施常规健康宣教,试验组30例除常规健康宣教外,在术前1天和术后6h2次进行疼痛教育,内容包括疼痛概念、术后疼痛原因、疼痛的评估方法、疼痛对机体造成的不良影响、常用的镇痛方法及优缺点。术后比较2组病人要求镇痛的人数及肛门排气时间、首次下床时间、48h睡眠时间。结果:试验组要求镇痛的人数高于对照组,试验组肛门排气时间、首次下床时间均早于对照组,48h睡眠时间长于对照组,各项比较有显著的统计学意义(P0.05)。结论:疼痛教育能改善术后镇痛的质量,减少并发症发生,促进病人早日康复。     

疼痛教育对肝部分切除病人疼痛认知度及术后康复的影响

目的通过疼痛教育,提高住院病人对术后疼痛及疼痛控制的认知度,提高对术后镇痛的接受程度。方法将136例拟行肝部分切除术的病人随机分为干预组（给予疼痛教育）和对照组（未给予疼痛教育）,每组各68例。干预组由责任护士实施一对一的疼痛教育,对照组未予疼痛教育。术后观察主动呼叫要求镇痛的例数、镇痛治疗的满意度、术后恢复情况、术后48h内睡眠时间等。结果干预组术后主动呼叫镇痛的例数、镇痛满意度均明显高于对照组,首次下床及肛门排气时间均早于对照组,术后48h睡眠时间显著长于对照组。结论疼痛教育能显著提高肝部分切除病人对疼痛控制的认知度,提高病人术后镇痛的接受程度。     

术前疼痛教育对结直肠癌手术患者术后康复的影响

目的观察术前疼痛教育对结直肠癌手术患者术后康复的影响。方法将50例结直肠癌手术患者按随机数字表分为对照组和观察组各25例。对照组行常规肛肠外科术前宣教,观察组在常规宣教基础上强化疼痛知识及评分方法教育。术后3d进行镇痛需求、镇痛治疗满意度、睡眠时间及首次肛门排气时间、首次下床时间的评估。结果观察组术后镇痛需求及镇痛治疗满意率明显高于对照组,术后睡眠时间多于对照组,术后首次下床活动时间、首次肛门排气时间及住院天数少于对照组。结论术前疼痛教育能提高结直肠癌手术患者术后镇痛治疗满意度及疗效,有利于术后康复。     

疼痛教育对腹部手术后患者疼痛的影响研究

目的探讨疼痛教育对腹部术后患者疼痛程度的影响。方法选择沈阳市第七人民医院2014-02—2015-01期间收治的160例患者为研究对象,随机分为试验组和对照组,对照组进行常规护理,试验组在常规护理基础上进行疼痛教育。干预后了解两组患者对疼痛相关知识的了解程度,术后镇痛效果及镇痛满意度,并记录患者首次肛门排气时间及下床时间、24 h睡眠时间及住院天数。结果术后试验组对疼痛的认知度高于对照组(P0.05);试验组的VAS值为(4.55±1.12)低于对照组的(6.08±0.66)(P0.05);试验组患者的镇痛满意度高于对照组(P0.05);试验组患者术后生理状况恢复情况明显优于对照组(P0.05)。结论疼痛教育有效缓解患者的疼痛程度,提高患者对镇痛的满意度,促进患者身体的恢复。     

无陪病区的手术后疼痛管理

目的探讨手术后疼痛管理在普外科无陪护理病区中开展的效果。方法（1）将2006年9～12月开展无陪护理后来我科住院并实施规范的手术后疼痛管理饷521例患者设为试验组；将2006年3～6月开展无陪护理前来我科住院并实施常规术后止痛的456例患者设为对照组。对2组患者的平均住院日、住院费用以对两组患者的首次肛门排气时间、首次下床时间、24h和48h睡眠时间、住院天数、住院费用以及患者对控制或减轻疼痛的措施及效果满意度六方面进行比较。结果试验组患者的住院天数、住院费用显著低于对照组（P〈0．01），而患者对控制或减轻疼痛的措施及效果满意度显著高于对照组，其中首次肛门排气时间及首次下床时间均提早于对照组，24h和48h睡眠时间显著长于对照组，促进了术后早日康复。结论在普外科无陪护理病区开展规范的手术后疼痛管理可有效改善术后镇痛质量，促进患者早日康复，缩短患者的住院天数，降低住院费用，提高患者的满意度。     

110°～145°侧卧位对缓解妇科腹腔镜术后非切口疼痛的效果观察

[目的]探讨110°～145°躯体侧卧位对缓解妇科腹腔镜手术CO2气腹所致术后非切口疼痛的效果.[方法]将100例进行妇科腹腔镜手术的病人随机分成对照组和实验组各50例.对照组采用常规护理方法于术后8 h采取自由体位,实验组除常规护理方法外于术后8 h采取110°～145°躯体侧卧位.由责任护士记录两组病人术后非切口疼痛缓解时间、术后肛门排气时间、术后自主下床活动时间.[结果]实验组病人术后非切口疼痛缓解效果优于对照组(P＜0.05),12 h内自主下床活动病人数高于对照组(P＜0.05),实验组24 h内肛门排气例数高于对照组(P＜0.05).[结论]110°～145°躯体侧卧位可以缓解妇科腹腔镜手术后非切口疼痛,提前肛门排气.     

From past pain to future pain through the pain of others: Information about other people's pain ratings can alleviate our subsequent pain

Background

Previous studies have shown that pain memories have a profound impact on subsequent pain experiences. This study investigated whether pain ratings derived from other people can modify an individual's memory of past pain. This study also examined whether pain memory modified by others' pain ratings determines subsequent pain experiences.

Methods

Participants were divided into two groups: an experimental group and a control group. Participants in both groups were exposed to pain stimulation; then, they recalled its intensity twice over a period of time; after a break, they were again exposed to pain stimulation of the same intensity. The final sample consisted of 53 participants. The only difference between the experimental group and the control group was that in the former the pain ratings of other alleged participants were presented between the two consecutive pain recalls. These ratings suggested that other people experienced the same pain as less intense.

Results

The pain ratings derived from other people did not alter the pain memory; nevertheless, they affected an individual's next pain experience even for a certain period of time after their presentation. This type of pain-related information shaped participants' subsequent pain experiences regardless of their empathy, conformity, and susceptibility to social influence.

Conclusions

Information on pain derived from other people not only shapes the response to a novel stimulation but also substantially modifies the subsequent experience of that stimulation.

Significance

The study demonstrates the importance of social information on pain and provides evidence that this type of information substantially modifies the subsequent experience of the same pain. These results suggest that social information on pain can be used to alleviate pain associated with recurring medical procedures and thus increase patients' willingness to continue treatment.     

Predicting pain and pain responses to opioids

The mechanisms behind the wide individual variability in pain experience and relief are an area of intense research activity. Predicting individual clinical pain and the responsiveness to analgesics should increase the efficacy and tolerability of analgesic treatments, and improve the overall treatment outcome. Several factors have shown validity in the prediction of pain, with most studies having been performed in postoperative pain. These factors include younger age, female gender, multiple psychosocial contributors (e.g. negative affect, somatisation, depressive mood, expectations, anxiety), pre-existing physical comorbidities and pain, information provided by carers, and the nature of the pain insult. Recent studies have shown quantitiative sensory testing at high stimulus intensity (e.g. pain thresholds), as well as specific genetic factors and the functional testing of the endogenous pain modulatory pathways as emerging useful tools in the study of individual pain variability.Many of the above factors are also relevant in the prediction of analgesic responsiveness. The predominant pain characteristics, pain chronicity and neuroplastic changes, opioid-related genetic factors and psychological factors (including placebo response components) are major determinants of analgesic efficacy. Prediction of analgesia using quantitative sensory tests has been studied with some success.Better prediction of individual pain and analgesic responsiveness promises to improve pain control and general treatment outcome, and reduce adverse events as well as costs. Further prospective studies with interdisciplinary input validating the usefulness of predictive variables within algorithms are encouraged in large patient cohorts.