中华护理杂志 ›› 2021, Vol. 56 ›› Issue (12): 1868-1875.DOI: 10.3761/j.issn.0254-1769.2021.12.018

• 证据综合研究 • 上一篇    下一篇

术后急性疼痛患者自控镇痛管理相关指南的系统评价

张俊峰(), 蔡莹莹, 郑可欣, 陈妙婷, 刘兴玲, 吴艳妮   

  1. 523325 广东省东莞市 东莞市松山湖中心医院护理部(张俊峰,刘兴玲),麻醉科(陈妙婷);揭阳市人民医院护理部(蔡莹莹);珠海市慢性病防治中心精神科(郑可欣);南方医科大学南方医院JBI循证护理合作中心(吴艳妮)
  • 收稿日期:2021-06-24 出版日期:2021-12-15 发布日期:2021-12-20
  • 作者简介:张俊峰:女,硕士(博士在读),副主任护师,护理部副主任,E-mail: feng06140119@126.com
  • 基金资助:
    东莞市社会科技发展项目(202050715024875)

A systematic review of guidelines on the management of patient-controlled analgesia in adult patients with postoperative acute pain

ZHANG Junfeng(), CAI Yingying, ZHENG Kexin, CHEN Miaoting, LIU Xingling, WU Yanni   

  • Received:2021-06-24 Online:2021-12-15 Published:2021-12-20

摘要:

目的 对术后急性疼痛患者自控镇痛(patient controlled analgesia,PCA)管理相关指南进行质量评价和内容分析,为制订术后急性疼痛PCA管理规范提供依据。方法 计算机检索国内外指南网、相关专业学会网站及数据库,检索术后疼痛PCA管理相关循证指南,检索时限为建库至2021年4月。应用临床指南研究与评价工具Ⅱ(appraisal of guidelines for research and evaluation instrument Ⅱ,AGREE Ⅱ)对指南进行质量评价,汇总术后疼痛PCA管理的推荐意见。 结果 初检到783篇文献,最终纳入9部指南,3部指南的总体质量评价为A级,6部为B级,整体质量较高。从9部指南中提取23条术后疼痛PCA管理相关推荐意见,涉及组织管理、教育与培训、镇痛模式的选择、患者教育、术前评估、术后监测与评估6个方面。 结论 纳入的指南质量整体较高,为术后急性疼痛PCA规范管理提供了依据,但在独立性、应用性领域有待提高;关于术后疼痛PCA管理的推荐意见散在分布,缺乏具体针对性的管理策略。

关键词: 术后疼痛, 患者自控镇痛, 指南, 质量评价, 循证护理学

Abstract:

Objective The quality evaluation and content analysis of the existing guidelines concerning management of patient-controlled analgesia(PCA) in adult patients with postoperative acute pain were conducted to provide recommendations for its management. Methods Evidence-based guidelines involving recommendations of PCA management with postoperative pain were searched in guidelines networks,websites of pain management and anaesthesiology,and databases from inception to April 2021. AGREE Ⅱ was used to appraise the quality of guidelines;the recommendations related to PCA management of postoperative pain were synthesized. Results A total of 783 pieces of the literature were initially detected,and finally 9 evidence-based guidelines were included,among which 3 were rated as A and 6 were rated as B,with the relatively high quality. 23 recommendations were extracted and summarized from 9 guidelines,involving 6 domains,namely organization management,education and training,analgesia mode selection,patient education,preoperative assessment,and postoperative monitoring and assessment. Conclusion The guidelines are of high quality in total,providing recommendations on PCA management of postoperative pain;however,the independence and applicability of the guidelines need to be improved. The recommendations of PCA management are scattered in different guidelines and lack targeted specific PCA management strategies.

Key words: Postoperative Pain, Patient-Controlled Analgesia, Guideline, Quality Appraisal, Evidence-Based Nursing