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穴位按摩对胸腔镜手术患者术后疼痛管理的有效性:随机对照试验

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作者:NursingResearch护理研究前

Full text

Purpose

More than 86% patients experience moderate to severe pain after thoracoscopic surgery. A combination of diverse nonpharmacological pain relief methods is a developing trend for pain management. The purpose of this study was to explore the effect of acupressure in reducing pain after thoracoscopic surgery.

Design

A Randomized controlled study with purpose sampling was used for this study. Patients who underwent thoracoscopic surgery at a medical center in central Taiwan were enrolled. Study data was collected from September 2020 to April 2021 after the approval of the institutional review board. A total of 100 participants were randomized into two groups (49 and 51 in the experimental and control groups, respectively).

Methods

Participants in the experimental group received acupressure at the Neiguan (PC6) and Shenmen (HT7) acupoints thrice a day for 2 days, whereas those in the control group received routine treatment and did not receive acupressure. The measurement included questionnaires for the collection of general information, physiological information, and disease rating scale. The Visual Analogue Scale-Pain (VAS-P) was used to measure the severity of pain. SPSS statistical software was used for data analysis. Independent sample t-test and chi-squared test were used for deive statistics, and paired t-test and linear mixed model were used to examine the effect of acupressure in alleviating pain.

Findings

After acupressure intervention, the pain score of the experimental group was lower than that of the control group, and this difference was significant β = 17.76, p < 0.001 on day 1 after intervention; β = 19.80, p < 0.001 on day 2 after intervention. The postoperative pain score in the experimental group on day 2 after intervention was significantly lower than that in the control group (t = 2.039, p = 0.044). After the subjects received acupressure, pain index significantly decreased after considering the interaction between time and group (p < 0.001). Regardless of the type of surgery, there were significant differences in pain index when the interaction between time and group was considered (p < 0.001).

Conclusions

This study provided an experimental basis that acupressure can help in pain management in patients after thoracoscopic surgery, and the pain relief results become more significant as the duration of intervention increases.

Clinical relevance

Acupressure is effective in relieving postoperative pain in any type of thoracoscopic surgery. Nurses can use acupressure to help control pain in patients after thoracoscopic surgery.

全文翻译(仅供参考)

目的

超过86%的患者在胸腔镜手术后有中度至重度疼痛。综合使用各种非药物止痛方法是疼痛管理的一个发展趋势。本研究的目的是探讨穴位按摩对减轻胸腔镜手术后疼痛的效果。

设计

本研究采用目的抽样的随机对照研究。在台湾中部的一个医疗中心接受胸腔镜手术的患者被纳入研究。研究数据在机构审查委员会批准后于2020年9月至2021年4月收集。共有100名参与者被随机分为两组(实验组和对照组分别为49和51)。

方法

实验组的参与者在内关(PC6)和神门(HT7)穴位接受穴位按摩,每天三次,持续2天,而对照组的参与者接受常规治疗,不接受穴位按摩。测量包括收集一般信息、生理信息和疾病评分表的调查问卷。视觉模拟量表-疼痛(VAS-P)被用来测量疼痛的严重程度。采用SPSS统计软件进行数据分析。独立样本t检验和卡方检验用于描述性统计,配对t检验和线性混合模型用于考察穴位按摩缓解疼痛的效果。

研究结果

穴位按摩干预后,实验组的疼痛评分低于对照组,这种差异在干预后第1天有显著性β=17.76,p<0.001;干预后第2天β=19.80,p<0.001。实验组在干预后第2天的术后疼痛评分明显低于对照组(t = 2.039,p = 0.044)。受试者接受穴位按摩后,考虑到时间和组别之间的交互作用后,疼痛指数明显下降(p < 0.001)。无论哪种手术类型,在考虑时间和组间的交互作用后,疼痛指数都有显著差异(p < 0.001)。

结论

本研究为穴位按摩有助于胸腔镜手术后患者的疼痛管理提供了实验依据,而且随着干预时间的延长,疼痛缓解效果也更加明显。

临床意义

穴位按摩可以有效缓解任何类型胸腔镜手术的术后疼痛。护士可以利用穴位按摩来帮助控制胸腔镜手术后病人的疼痛。

原文链接:

https://doi.org/10.1111/jnu.12751

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