摘要
目的:考察临床药师参与骨科围手术期疼痛管理规范化用药流程的效果。方法:采用回顾性研究方法,选取2015年1～12月收治入四川省人民医院行骨科手术的305例各类骨折患者的资料,根据镇痛方式的不同将患者分为观察组159例和对照组146例。前者按临床药师与医师共同制订的"围手术期疼痛管理规范化用药流程"即多模式镇痛方案给药,后者行常规镇痛。比较两组患者术前和术后疼痛评分和用药期间的药品不良反应。结果:术后12,36,48,72 h,观察组镇痛效果明显优于对照组,数字评价量表法(NRS)差异有统计学意义(P <0. 001),而两组间药品不良反应发生率差异无统计学意义(P>0. 05)。结论:骨科围手术期疼痛管理规范化流程能够有效缓解手术切口疼痛,且不增加药品不良反应的发生;临床药师参与骨科围手术期镇痛管理,可以优化镇痛规范化流程,对加快骨科手术患者术后恢复具有积极意义。
Objective: To study the effect of clinical pharmacist participating in standardized process management for the patients with perioperative pain in orthopedics department. Methods: Totally 305 fracture patients who needed operation and hospitalized in orthopedics department of Sichuan provincial people’s hospital during January and December in 2015 were selected according to the inclusion criteria and divided into the observation group(159 cases) and the control group(146 cases) in a retrospective study. The former was treated according to the perioperative pain management standardization medication process with the multimodal analgesic regimen formulated by clinical pharmacists and physicians,and the latter underwent the routine analgesia. The demographic data,fracture type and position of surgery and anesthesia,analgesic therapy,pain score before and after surgery,drug adverse reactions during therapy and so on were recorded. The analgesic effects and adverse drug reactions of the patients were compared between the groups. Results: At 12,36,48,72 h after the operation,the evaluation results showed that the analgesic effect of the observation group was significantly better than that of the control group,and the difference in numerical rating scale( NRS) had much significant difference( P <0. 001),and the differences in adverse drug reactions between the groups had no statistically significant difference( P > 0. 05). Conclusion: The perioperative pain management standardization medication process can effectively relieve the incision pain of patients and reduce the inflammatory reaction without increasing the incidence of adverse drug reactions. Clinical pharmacists participating in perioperative analgesia management can optimize the analgesic standardization medication process of orthopedics department,which exhibits great significance to speed up the recovery of patients after operation.
作者
陈岷
李获
龙恩武
陈鸣
Chen Min;Li Huo;Long Enwu;Chen Ming(Department of Pharmacy,Sichuan Provincial People's Hospital,Sichuan Academy of Medical Science,Personalized Drug Therapy Key Laboratory of Sichuan Province,Chengdu 610072,China)
出处
《中国药师》
CAS
2018年第12期2145-2148,共4页
China Pharmacist
基金
国家临床药学重点专科建设项目(编号:30305030698)
关键词
骨科
围手术期疼痛管理
规范化流程
多模式镇痛
超前镇痛
疼痛评分
Department of orthopedics
Perioperative pain management
Standardized process
Multimodal analgesia
Preemptive analgesia
Pain score
