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静脉自控舒芬太尼镇痛与音乐疗法对肺癌手术后疼痛及血流动力学的影响:一项随机平行研究

Effects of Intravenous Patient-Controlled Sufentanil Analgesia and Music Therapy on Pain and Hemodynamics After Surgery for Lung Cancer: A Randomized Parallel Study.

作者信息

Wang Yichun, Tang Haoke, Guo Qulian, Liu Jingshi, Liu Xiaohong, Luo Junming, Yang Wenqian

机构信息

1 Department of Anesthesiology, Xiangya Hospital, Central South University , Changsha, Hunan Province, China .

2 Department of Critical Care Medicine, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University , Changsha, Hunan Province, China .

出版信息

J Altern Complement Med. 2015 Nov;21(11):667-72. doi: 10.1089/acm.2014.0310. Epub 2015 Sep 2.

Abstract

OBJECTIVE

Postoperative pain is caused by surgical injury and trauma; is stressful to patients; and includes a series of physiologic, psychological, and behavioral reactions. Effective postoperative analgesia helps improve postoperative pain, perioperative safety, and hospital discharge rates. This study aimed to observe the influence of postoperative intravenous sufentanil patient-controlled analgesia combined with music therapy versus sufentanil alone on hemodynamics and analgesia in patients with lung cancer.

METHODS

This was a randomized parallel study performed in 60 patients in American Society of Anesthesiologists class I or II undergoing lung cancer resection at the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University. Patients were randomly assigned to a music therapy (MT) group and a control (C) group. The MT group underwent preoperative and postoperative music intervention while the C group did not. Both groups received intravenous patient-controlled sufentanil analgesia. The primary outcome was the visual analogue scale (VAS) score at 24 hours after surgery. The secondary outcomes included hemodynamic changes (systolic blood pressure, diastolic blood pressure, heart rate), changes on the Self-Rating Anxiety Scale (SAS), total consumption of sufentanil, number of uses, sedation, and adverse effects. The postoperative sufentanil dose and analgesia frequency were recorded.

RESULTS

Compared with the C group, the MT group had significantly lower VAS score, systolic and diastolic blood pressure, heart rate, and SAS score within 24 hours after surgery (p < 0.01). In addition, postoperative analgesia frequency and sufentanil dose were reduced in the MT group (p < 0.01).

CONCLUSIONS

Combined music therapy and sufentanil improves intravenous patient-controlled analgesia effects compared with sufentanil alone after lung cancer surgery. Lower doses of sufentanil could be administered to more effectively improve patients' cardiovascular parameters.

摘要

目的

术后疼痛由手术损伤和创伤引起;给患者带来压力;并包括一系列生理、心理和行为反应。有效的术后镇痛有助于改善术后疼痛、围手术期安全性和出院率。本研究旨在观察肺癌患者术后静脉自控镇痛联合音乐疗法与单纯舒芬太尼对血流动力学和镇痛的影响。

方法

这是一项随机平行研究,对中南大学湘雅医学院附属肿瘤医院60例美国麻醉医师协会分级为I或II级的肺癌切除术患者进行。患者被随机分为音乐疗法(MT)组和对照组(C)组。MT组在术前和术后接受音乐干预,而C组不接受。两组均接受静脉自控舒芬太尼镇痛。主要结局是术后24小时的视觉模拟评分(VAS)。次要结局包括血流动力学变化(收缩压、舒张压、心率)、自评焦虑量表(SAS)变化、舒芬太尼总消耗量、使用次数、镇静情况和不良反应。记录术后舒芬太尼剂量和镇痛频率。

结果

与C组相比,MT组术后24小时内VAS评分、收缩压、舒张压、心率和SAS评分显著更低(p < 0.01)。此外,MT组术后镇痛频率和舒芬太尼剂量降低(p < 0.01)。

结论

与肺癌手术后单纯使用舒芬太尼相比,音乐疗法联合舒芬太尼可改善静脉自控镇痛效果。可给予更低剂量的舒芬太尼以更有效地改善患者的心血管参数。

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