■术后疼痛是儿童手术常见且令人痛苦的后果。它可以导致痛苦,长时间恢复,身体功能受损,甚至慢性疼痛。有效的术后疼痛管理对于改善患者预后至关重要。然而,有几个因素阻碍了儿童疼痛的准确评估和管理,特别是在低收入国家。本研究旨在评估儿科患者术后疼痛的严重程度并确定其预测因素。
■于2023年1月至4月在亚的斯亚贝巴公立医院对235名2个月-7岁的儿科手术患者进行了纵向研究。主要结果,疼痛严重程度,使用疼痛评估工具在三个不同的时间进行评估。Cochran的q检验用于比较术后疼痛发生率。广义估计方程用于确定随时间变化的预测变量对疼痛严重程度的影响。该研究证明了使用具有95%CI的AOR的相关性和显著性的方向,P值为0.05。
■术后12h中重度疼痛发生率为36.6%,24h时20%,36h时10%。术前疼痛和术前焦虑的患者更容易出现中度至重度术后疼痛[调整比值比(AOR)分别为3.41,CI=1.15,10.00和AOR=2.28,CI=1.219,4.277)。术后疼痛严重程度的术中预测因素包括手术持续时间较长(AOR=6.62,CI=1.90,23.00)和大手术(AOR=5.2,CI=2.11,12.88)。接受多模式镇痛的患者术后疼痛严重程度降低(AOR=0.24;CI=0.091,0.652),术后评估频繁的患者(AOR=0.09;CI=0.022,0.393)。
■本研究中相当一部分儿科手术患者术后疼痛程度较高,影响疼痛严重程度的最重要因素是术后疼痛管理策略和评估实践。
UNASSIGNED: Postoperative pain is a common and distressing consequence of surgery in children. It can lead to suffering, prolonged recovery, impaired physical functioning, and even chronic pain. Effective postoperative pain management is crucial for improving patient outcomes. However, several factors hinder the accurate assessment and management of pain in children, particularly in low-income countries. This
study aims to evaluate the severity of postoperative pain in paediatric patients and identify its predictors.
UNASSIGNED: A longitudinal
study was conducted on 235 paediatric surgical patients aged 2 months-7 years in Public Hospitals of Addis Ababa from January to April 2023. The primary outcome, pain severity, was assessed at three different times using a pain assessment tool. Cochran\'s q-test was used to compare postoperative pain incidences. The Generalized Estimating Equation was used to determine predictor variables\' effects on pain severity over time. The
study demonstrated the direction of association and significance using an AOR with a 95% CI at a P value of 0.05.
UNASSIGNED: The incidence of moderate to severe postoperative pain was 36.6% at 12 h, 20% at 24 h, and 10% at 36 h. Patients with preoperative pain and preoperative anxiety were more likely to experience moderate to severe postoperative pain [adjusted odds ratio (AOR)=3.41, CI=1.15, 10.00 and AOR=2.28, CI=1.219, 4.277, respectively). Intraoperative predictors of postoperative pain severity included longer duration of surgery (AOR=6.62, CI=1.90, 23.00) and major surgery (AOR=5.2, CI=2.11, 12.88). Postoperative pain severity was reduced in patients receiving multimodal analgesia (AOR=0.24; CI=0.091, 0.652) and in patients assessed frequently in the postoperative period (AOR=0.09; CI=0.022, 0.393).
UNASSIGNED: A significant portion of paediatric surgical patients in this
study experienced high levels of postoperative pain, particularly within the first 24 h. The most influential factors affecting pain severity were postoperative pain management strategies and assessment practices.