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An Interactive Pain Application (MServ) Improves Postoperative Pain Management

机译:互动疼痛申请(MSERV)改善了术后疼痛管理

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Background. Most patients have moderate or severe pain after surgery. Opioids are the cornerstone of treating severe pain after surgery but cause problems when continued long after discharge. We investigated the efficacy of multifunction pain management software (MServ) in improving postoperative pain control and reducing opioid prescription at discharge. Methods. We recruited 234 patients to a prospective cohort study into sequential groups in a nonrandomised manner, one day after major thoracic or urological surgery. Group 1 received standard care (SC, n?=?102), group 2 were given a multifunctional device that fed back to the nursing staff alone (DN, n?=?66), and group 3 were given the same device that fed back to both the nursing staff and the acute pain team (DNPT, n?=?66). Patient-reported pain scores at 24 and 48 hours and patient-reported time in severe pain, medications, and satisfaction were recorded on trial discharge. Findings. Odds of having poor pain control (1 on 0–4 pain scale) were calculated between standard care (SC) and device groups (DN and DNPT). Patients with a device were significantly less likely to have poor pain control at 24 hours (OR 0.45, 95% CI 0.25, 0.81) and to report time in severe pain at 48 hours (OR 0.62, 95% CI 0.47–0.80). Patients with a device were three times less likely to be prescribed strong opioids on discharge (OR 0.35, 95% CI 0.13 to 0.95). Interpretation. Using an mHealth device designed for pain management, rather than standard care, reduced the incidence of poor pain control in the postoperative period and reduced opioid prescription on discharge from hospital.
机译:背景。大多数患者手术后疼痛中度或严重疼痛。阿片类药物是治疗手术后严重疼痛的基石,但在放电后持续时造成问题。我们调查了多功能疼痛管理软件(MSERV)在改善术后疼痛控制和降低放电阿片类药物的疗效。方法。我们招募了234名患者,以非沉积的方式将前瞻性队列研究进入连续的群体,在主要胸部或泌尿外科手术后一天。第1组接收标准护理(SC,N?=α102),第2组被赋予多功能装置,单独送回护理人员(DN,N?=Δ66),并且第3组被赋予相同的设备回到护理人员和急性痛苦队(DNPT,N?=?66)。患者报告的疼痛分数在24和48小时,患者报告的患者报告的严重疼痛,药物和满意度进行了试验。发现。在标准护理(SC)和器件组(DN和DNPT)之间计算疼痛疼痛疼痛(疼痛1的疼痛量)的含量。装置患者在24小时(或0.45,95%CI 0.25,0.25,0.81)时疼痛控制差,并在48小时(或0.62,95%CI 0.47-0.80)中报告严重疼痛的时间。患有装置的患者在放电(或0.35,95%CI 0.13至0.95)上规定强的阿片类药物的三倍。解释。使用专为疼痛管理而设计的MHEALTE设备而不是标准护理,减少了术后期间疼痛控制差的发生率,降低了从医院排放的阿片类药物处方。

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