Effects of multimodal analgesia on postoperative rehabilitation in patients with lower limbs free flap transplantation
10.3760/cma.j.issn.1674-2907.2016.35.011
- VernacularTitle:多模式镇痛对下肢游离皮瓣移植患者术后康复效果的影响
- Author:
Chengting SHU
1
;
Chunyan SUN
;
Jinghua YANG
;
Huijuan SONG
Author Information
1. 510282 广州，南方医科大学珠江医院质量管理科
- Keywords:
Pain measurement;
Skin flap transplantation;
Multimodal analgesia;
Postoperative care
- From:
Chinese Journal of Modern Nursing
2016;22(35):5072-5075
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of multimodal analgesia on postoperative rehabilitation in patients with lower limbs free flap transplantation. Methods A total of 100 patients scheduled for lower limbs free flap transplantation of department of traumatology and orthopedics were recruited from December 2013 to March 2015 in Nanfang Hospital of Southern Medical University. They were randomly divided into experimental group ( 50 cases, multimodal analgesia including patient-controlled analgesia, oral or vein painkillers on schedule and ration, on demand) and control group ( 50 cases, analgesia on demand, giving routine analgesia medicine according to the actual demands of patients). The effects of analgesia and sedation, sleep quality, satisfaction degree of patients towards discharge, the situation of angiospasm, the blood flow of skin flaps blood-vessels were compared between two groups. Results Repeat measurement of variance analysis results showed that there were significant differences among scores of the visual analogue scale ( VAS) on postoperative patients with multimodal analgesia in different time points (8, 16, 24, 32, 40, 48h after operation) (Ftime=9.89, P<0. 01) . The differences of VAS scores between experimental group and control group was statistically significant (Fbetweengroup=4.84, P<0.05). Time effect and intervention interacted with each other (Finteraction=2.27, P<0. 05) . There were no significant differences among scores of Ramesay on postoperative patients with multimodal analgesia in different time points (8, 16, 24, 32, 40, 48h after operation) (Ftime=1.29, P>0.05). Statistical significance was found in Ramesay scores between experimental group and control group was ( Fbetween group=6.84, P<0.05) . Time effect and intervention interacted with each other ( Finteraction=5.41, P<0.05) . The score of sleep quality (3.7±1.1) in experimental group were lower than that in control group (5.2±1.9). The blood flow velocity of skin flaps blood-vessels in experimental group [(7.21±1.84) mm/s] was higher than that in control group [(6.21±1.43) mm/s] (t=2.254, P<0.05). The tension of skin flap in experimental group [(7.63± 1. 23) N] was lower than that in control group [(8.24±2.01) N]. Differences were statistically significant (t=2. 771, 2. 254, 2.006;P<0.05). Conclusions The multimodal analgesia can improve the effects of analgesia and sedation, sleep quality and microcirculation of local skin slaps in patients with lower limbs free flap transplantation.
