摘要
目的探讨FLACC与CRIES疼痛评估量表用于婴幼儿术后疼痛评估的相关性与差异性。方法随机选取择期行外科手术的婴幼儿67例,包括开腹手术、腹腔镜手术和会阴部手术,ASA分级I^II级,年龄2个月~3岁,体重4.3~16.5 kg。所有患儿均于入手术室后静脉麻醉诱导前行术前状态评估,七氟醚、瑞芬太尼和丙泊酚静吸复合麻醉术中维持,随机采用不同的术后镇痛方式。用FLACC评估量表与CRIES评估量表分别于患儿苏醒时、转出苏醒室时、转入病房2、6 h和12 h对患儿行术后疼痛评估。对每个时间点的疼痛评分进行相关性和差异性分析,比较两种量表评估婴幼儿镇痛的特点,进行患儿术前状态与术后疼痛评分的相关性分析。结果在苏醒时、转出苏醒室时及病房的各个时间段FLACC评估量表评分与CRIES评估量表评分之间存在强线性正相关关系(P<0.05),但在婴幼儿转出苏醒室时和转入病房早期时FLACC量表评分较CRIES量表评分更低(P<0.05)。两种评估量表与术前状态评分无明显相关关系(P>0.05)。结论FLACC与CRIES疼痛评估量表评估结果正向相关,两者与术前状态评分均无关。FLACC与CRIES疼痛评估量表均可作为评估镇痛程度的工具,CRIES疼痛评估量表较FLACC疼痛评估量表可更早发现患儿术后镇痛不足情况,以尽早完善镇痛。
Objective To explore the correlation and difference between FLACC and CRIES pain assessment scale in postoperative pain assessment of infants.Methods A total of 67 infants randomly selected for undergoing elective surgery,including laparotomy,laparoscopic surgery and perineal surgery,ASA grade I to II,aged 2 to 3 years old,and weighing 4.3 to 16.5 kg would be evaluated preoperative state between entering the operating room and the induction of intravenous anesthesia.Sevoflurane,remifentanil,and propofol were administered during static anesthesia,and different postoperative analgesics were used randomly.All the infants was observed for pain responses using FLACC and CRIES during the child’s wake period and the postoperative 2 hour,6 hour and 12 hour in the ward.The correlation and difference of pain scores at each time point were analyzed,and the characteristics of infant analgesia evaluated by the two scales were compared.The correlation between the preoperative status and the postoperative pain score was analyzed.Results There is a strong linear positive correlation between the FLACC assessment scale score and the CRIES assessment scale score during the wake-up period and each time period of the ward(P<0.05),but the FLACC scale score was lower than the CRIES scale score when infants and children were removed from the recovery room and early in the ward(P<0.05).There was no significant correlation between the two assessment scales and preoperative state scores(P>0.05).Conclusion The results of the FLACC and CRIES pain assessment scales were positively correlated,and neither was related to the preoperative state score.The FLACC and CRIES pain assessment scales both can be used as a tool to assess the degree of analgesia,but the CRIES pain assessment scale can detect the postoperative analgesia in infants earlier than the FLACC pain assessment scale,so as to improve the analgesia as soon as possible.
作者
张原源
周军
ZHANG Yuan-yuan;ZHOU Jun(Department of Anesthesiology and Perioperative Medicine,Henan Provincial People’s Hospital of Henan University,Zhengzhou 450003,China)
出处
《医药论坛杂志》
2020年第2期22-25,共4页
Journal of Medical Forum
