Pain levels experienced with activities after cardiac surgery
Pain levels experienced with activities after cardiac surgery
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DOI：
10.4037/ajcc2004.13.2.116
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发表时间：
2004-03-01
影响因子：
2.7
通讯作者：
Beckman, D
中科院分区：
文献类型：
--
作者：
Milgrom, LB;Brooks, DA;Beckman, D
背景急性疼痛是心脏手术后常见的疾病，可使患者无法参与预防术后并发症的活动。目的描述心脏手术后患者术后第1~6天的疼痛程度，以及拔除胸管和拔管后疼痛程度的变化。方法对接受心脏手术的成年人在术后第1~6天对与各种活动相关的疼痛程度进行评分，并根据术后天数、活动度和心脏手术类型进行比较。分析拔管前后疼痛评分。结果术后早期疼痛评分较高。活动(P<；.01)的总体疼痛得分从高到低依次为咳嗽、床上活动或翻身、起床、深呼吸或使用激励性肺活量计和休息。咳嗽(P=0.03)和深呼吸或使用激励性肺活量计(P=0.005)的疼痛变化在手术组之间随着时间的推移有显著差异。停用胸管后，患者休息时(P=0.01)、咳嗽时(P=0.05)、起床时(P=0.03)疼痛程度较轻。对疼痛进行全面的、个性化的评估，包括活动水平，对于促进令人满意的疼痛管理是必要的。
BACKGROUND Acute pain is common after cardiac surgery and can keep patients from participating in activities that prevent postoperative complications. Accurate assessment and understanding of pain are vital for providing satisfactory pain control and optimizing recovery.OBJECTIVES To describe pain levels for 5 activities expected of patients after cardiac surgery on post-operative days 1 to 6 and changes in pain levels after chest tube removal and extubation.METHODS Adults who underwent cardiac surgery were asked to rate the pain associated with various types of activities on postoperative days 1 to 6. Pain levels were compared by postoperative day, activity, and type of cardiac surgery. Pain scores before and after chest tube removal and extubation also were analyzed.RESULTS Pain scores were higher on earlier postoperative days. The order of overall pain scores among activities (P < .01) from highest to lowest was coughing, moving or turning in bed, getting up, deep breathing or using the incentive spirometer and resting. Changes in pain reported with coughing (P = .03) and deep breathing or using the incentive spirometer (P = .005) differed significantly over time between surgery groups. After chest tubes were discontinued, patients had lower pain levels at rest (P = .01), with coughing (P = .05), and when getting up (P = .03).CONCLUSIONS Pain relief is an important outcome of care. A comprehensive, individualized assessment of pain that incorporates activity levels is necessary to promote satisfactory management of pain.