NONPHARMACOLOGIC ANALGESIA FOR INVASIVE PROCEDURES

描述(摘自申请者S摘要)：止痛药 用于在微创外科手术中控制疼痛 疗效有限，副作用严重，成本高。这个 这项研究的长期目标是提供一种经济有效和安全的 侵入性治疗中减轻疼痛和静脉用药的行为方法 程序。一般来说，这些程序的止痛依赖于 使用麻醉剂和镇静剂进行静脉清醒镇静。外推 静脉清醒镇静的风险取决于手术的次数，我们 预计每年将有47,000名患者患有严重的心肺疾病 并发症和2600人死亡。 我们建议非药物止痛用于急性呼吸窘迫综合征的安全治疗 程序上的痛苦。非药物止痛包括放松训练， 自我催眠，以及操作组成员使用的引导图像。 具体目标是：(1)前瞻性地确定 微创手术中非药物镇痛对疼痛和用药的影响 程序，(2)评估非药物止痛的效果 微创手术的安全性，以及(3)决定 资源利用中的非药物止痛。我们假设 非药物止痛可减少疼痛和静脉用药需求 在微创手术过程中，提高了手术安全性，并减少了 与传统静脉镇痛法的资源需求比较。 完成后，围手术期非药物性给药 止痛药将在320年度通过严格和实际的评估得到验证 病人。非药物止痛的相对效果将是 与井中护理和移情注意力控制的标准相比 受控监控环境下的特色化人口 忙碌的介入放射学实践。非药理学的整合 将止痛纳入急性疼痛的主流管理，以提供 设计一项更大规模研究的基础，以确定 多中心随机试验。

DESCRIPTION (Adapted from the Applicant s Abstract): Analgesics administered to control pain during minimally invasive surgical procedures have limited effectiveness, serious side effects, and high cost. The long-term objective of this research is to provide a cost-effective and safe behavioral method for reducing pain and intravenous drug use during invasive procedures. Analgesia for these procedures, in general, relies on intravenous conscious sedation with narcotics and sedatives. Extrapolating the risk of intravenous conscious sedation to the number of procedures, we predict annually 47,000 patients to suffer serious cardiorespiratory complication and 2,600 deaths. We propose nonpharmacologic analgesia for safe management of acute procedural pain. Nonpharmacologic analgesia includes relaxation training, self-hypnosis, and guided imagery applied by a member of the operating team. The specific aims are: (1) prospectively determine the effect of nonpharmacologic analgesia on pain and drug use during minimally invasive procedures, (2) assess the effect of nonpharmacologic analgesia on the safety of minimally invasive procedures, and (3) determine the effect of nonpharmacologic analgesia on resource utilization. We hypothesize that nonpharmacologic analgesia reduces pain and need for intravenous drugs during minimally invasive procedures, improves procedure safety, and reduces resource requirements compared with conventional intravenous analgesia. On completion, the periprocedural administration of nonpharmacologic analgesia will be validated by a rigorous and practical assessment in 320 patients. The relative performance of nonpharmacologic analgesia will be compared to a standard of care and empathic attention control in a well characterized population under the controlled monitored environment of a busy interventional radiology practice. Integration of nonpharmacologic analgesia into mainstream management of acute pain will be done to provide the basis for design of a larger study to determine clinical utility in a multicenter randomized trial.