Comparison of the effects of multimodal analgesia and conventional analgesia in the management of procedural pain in ICU
多模式镇痛与常规镇痛在ICU操作性疼痛管理中的效果比较

摘要

目的 比较重症患者多模式镇痛与常规镇痛在ICU操作性疼痛管理中的临床效果。方法 选取74例ICU患者作为研究对象，采用随机数字表法分为观察组和对照组，每组37例。观察组采用多模式镇痛方案，对照组采用常规镇痛方案。比较两组患者住ICU时间、气管插管时间、停药后苏醒时间、并发症发生率、ICDSC评分及CPOT评分。结果 观察组住ICU时间（5.6±2.15天）、气管插管时间（3.62±0.76天）及停药后苏醒时间（0.88±0.34小时）均显著短于对照组（7.18±2.33天、5.38±0.91天、1.76±0.29小时），差异有统计学意义（P<0.05）。观察组并发症发生率为8.11%，显著低于对照组的29.73%（P<0.05）。术后12、24、48小时，观察组ICDSC评分（4.12±1.45分、3.06±0.81分、1.82±0.68分）均显著低于于对照组（4.19±1.50分、3.93±0.76分、3.29±0.70分），CPOT评分（6.46±0.94分、4.97±0.72分、3.66±0.45分）均显著低于对照组（7.1±0.90分、5.78±0.69分、5.01±0.39分），差异均有统计学意义（P<0.05）。结论 多模式镇痛方案可有效缩短重症患者住ICU时间、气管插管时间及停药后苏醒时间，降低并发症发生率，改善认知功能，减轻疼痛程度，值得在ICU临床推广应用。

Abstract

Objective To compare the clinical effects of multimodal analgesia and conventional analgesia in the management of procedural pain in critically ill patients in the ICU.
Methods A total of 74 ICU patients were selected as the research subjects and were divided into the observation group and the control group using a random number table method, with 37 cases in each group. The observation group used a multimodal analgesia regimen, while the control group used a conventional analgesia regimen. The length of stay in the ICU, duration of tracheal intubation, time to awakening after discontinuation of medication, incidence of complications, ICDSC score, and CPOT score were compared between the two groups.
Results The length of stay in the ICU(5.6±2.15 days),duration of tracheal intubation(3.62±0.76 days),and time to awakening after discontinuation of medication(0.88±0.34 hours)in the observation group were all significantly shorter than those in the control group(7.18±2.33 days,5.38±0.91 days,1.76±0.29 hours),with statistical significance(P<0.05).The incidence of complications in the observation group was 8.11%,which was significantly lower than that of the control group at 29.73%(P<0.05).At 12,24,and 48 hours postoperatively, the ICDSC scores(4.12±1.45,3.06±0.81,1.82±0.68)and CPOT scores(6.46±0.94,4.97±0.72,3.66±0.45)in the observation group were all significantly lower than those in the control group(4.19±1.50,3.93±0.76,3.29±0.70 for ICDSC;7.1±0.90,5.78±0.69,5.01±0.39 for CPOT),with statistical significance(P<0.05).
Conclusion   The multimodal analgesia regimen can effectively shorten the length of stay in the ICU, duration of tracheal intubation, and time to awakening after discontinuation of medication for critically ill patients, reduce the incidence of complications, improve cognitive function, and alleviate pain, and is worthy of promotion and application in clinical practice in the ICU.