ANALGESIC THERAPY OUTCOMES IN THE EMERGENCY DEPARTMENT

迄今为止，急诊科（艾德）患者的疼痛严重 管理和研究不足。 护士在艾德中扮演重要角色 疼痛管理，包括给予止痛药和监测 镇痛治疗的有利和不利结果。 然而，实际上， 没有关于疼痛或镇痛治疗的护理研究 艾德患者的结局。 这项双盲随机临床试验将测试 三种镇痛药，静脉注射（IV）酮咯酸30 mg，静脉注射硫酸吗啡 5 mg，静脉注射硫酸吗啡10 mg，在选定的艾德患者中， 痛苦 该研究检查：（a）镇痛作用（即，总疼痛 强度差异和急救药物的使用）;（B）患者 镇静水平;（c）患者对疼痛治疗的满意度;以及（d） 治疗费用。 研究样本为336名讲英语和西班牙语的患者（112名 三个药物组中的每一个）， 剧烈的疼痛。 患者将在手术前立即评估其疼痛强度 并在三小时内连续九次。 镇静剂会 同时评估。 三个小时后，病人将 接受采访，了解他们对疼痛治疗的满意度， 收到。 计划成对比较，采用总体单因素ANOVA设计， 将测试组间的“总疼痛强度”差异 差异”评分、镇静水平、患者满意度、特定 可能影响患者满意度的因素，以及 治疗 Mann-Whitney成对比较将检验差异 使用的急救药物数量。 采访 将使用持续比较法分析成绩单， 从患者对疼痛的评估中确定主题 治疗 这项研究将是第一次全面的风险效益比分析 艾德患者疼痛的镇痛治疗。它将产生 直接适用于护理在艾德疼痛管理中角色知识 并为未来的护理和多学科提供方向 对艾德患者疼痛管理的调查。

Pain in Emergency Department (ED) patients has, heretofore, been grossly under-managed and under-studied. Nurses have a significant role in ED pain management, which includes administering analgesics and monitoring beneficial and adverse outcomes of analgesic therapy. Yet, virtually no nursing research has been conducted on pain or analgesic therapy outcomes in ED patients. This double-blind, randomized clinical trial will test the effects of three analgesics, intravenous (IV) ketorolac 30 mg, IV morphine sulfate 5 mg, and IV morphine sulfate 10 mg in selected ED patients with acute pain. The study examines: (a) analgesic effects (i.e., summed pain intensity differences and use of rescue medications); (b) patient sedation levels; (c) patient satisfaction with pain treatment; and (d) cost of treatment. The study sample will be 336 English- and Spanish-speaking patients (112 in each of the three drug groups) who present to the ED in moderate to severe pain. Patients will rate their pain intensity immediately before and at nine subsequent times over three hours. Sedation will be assessed at the same times. After three hours, patients will be interviewed about their satisfaction with the pain treatment they received. Planned pairwise comparisons, using an overall one-way ANOVA design, will test differences between groups in "summed pain intensity differences" scores, levels of sedation, patient satisfaction, specific factors that could influence patient satisfaction, and costs of treatment. Mann-Whitney pairwise comparisons will test differences between groups in number of rescue medications used. Interview transcripts will be analyzed, using the constant comparative method, to identify themes derived from patients' evaluations of their pain treatment. This study will be the first comprehensive risk-benefit ratio analysis of analgesic treatment of ED patients in pain. It will generate knowledge directly applicable to nursing's role in ED pain management and provide direction to future nursing and multidisciplinary investigations of pain management in ED patients.