剖宫产术后护理进展论文(精选3篇)

时间:2024-04-03 08:02:18 作者:admin

剖宫产术后护理进展论文 第1篇

术后疼痛控制不佳,不利于任何类型手术的恢复。疼痛可能会延长患者的恢复和延迟出院,对术后康复也有负面影响。剖宫产时,疼痛评分高有可能影响患者早期活动和母亲独立照顾新生婴儿的能力。多模式镇痛是剖宫产术后疼痛护理的一个关键组成部分,作为快速康复护理恢复方案的一部分,多模式镇痛可以减少副作用,加快术后恢复.[3][4][5]

剖宫产术后镇痛可通过一些术中干预措施来增强如:长效鞘内阿片类药物,如_,可在剖宫产术后数小时内提供镇痛作用,但会产生恶心、呕吐和呕吐等副作用,在没有长效鞘内阿片类药物的情况下,腹横肌平面阻滞能很好地控制术后疼痛,Cochrane对局部浸润镇痛和腹部神经阻滞的研究发现,它们能提高剖宫产术后镇痛效果.[6][7][8]

通过一个对口服镇痛用于剖宫产术后镇痛的综诉得出结论,没有足够的证据就最安全和最有效的镇痛方法,尽管如此,围手术期应用非甾体抗炎药(NSAIDs)可减轻剖宫产术后疼痛的产生。目前产科人群对扑热息痛的应用证据,还不太清楚,对包括剖宫产患者在内的术后人群进行了系统回顾研究,发现几乎所有英国的单位都在剖宫产术后使用扑热息痛和扑热息痛非甾体抗炎药来缓解疼痛。这种联合镇痛疗法廉价、有效、易于管理,并且可以避免阿片类药物,从而减少阿片类药物相关的副作用,并且与ERAS方案兼容。[9][10][11]

总结与建议

建议采用包括常规非甾体抗炎药和扑热息痛在内的多模式剖宫产术后镇痛,以增强剖宫产术后的康复。(证据等级:中等;推荐等级:强)

剖宫产术后护理进展论文 第2篇

Poor postoperative pain control may be detrimental to recovery for surgery of any kind. Pain may prolong recovery and delay dischargeand has a negative impact on cesarean delivery, high pain scores have the potential to prevent early mobilization and the mother's efforts to be independent and to care for her newborn baby. Multimodal analgesia is a key component in the management of postoperative pain as part of an enhanced recovery protocol,which results in fewer side-effects and faster postoperative recovery.[3][4][5]

Postcesarean delivery analgesia may be enhanced by a number of intraoperative intrathecal opioids, such as morphine, provide analgesia for several hours after cesarean delivery, although at the expense of a number of side-effects that include nausea, vomiting, http:// the absence of long-acting intrathecal opioids, the transversus abdominis plane field block provides excellent postoperative pain Cochrane review of local analgesia infiltration and abdominal nerve blocks found that they improved postoperative analgesia for cesarean delivery.[6][7][8]

A review of oral analgesia for postcesarean delivery pain relief concluded that there was insufficient evidence to make recommendations regarding the safest and most , the perioperative administration of nonsteroidal antiinflammatory drugs (NSAIDs) is known to diminish postoperative pain for cesarean in the obstetric population is less clear for paracetamol, although a systematic review of studies that included studies in which patients underwent cesarean delivery found that the combination of NSAIDs and paracetamol was A survey of practice surrounding cesarean delivery in the United Kingdom found that almost all units were using postoperative paracetamol and combination is cheap, effective, easy to administer, and opioid-sparing, which leads to fewer opioid-related side-effects,and is compatible with ERAS regimens.[9][10][11]

Summary and recommendation

Multimodal postoperative analgesia that includes regular NSAIDs and paracetamol is recommended for enhanced recovery for cesarean delivery. (Evidence level: moderate; recommendation grade: strong.)

剖宫产术后护理进展论文 第3篇

[1] .Steenhagen E. Enhanced recovery after surgery: It's time to change practice! Nutr Clin Pract 2016;31:18–29.

[2].Elias KM. Understanding enhanced recovery after surgery guidelines: An introductory approach. J Laparoendosc Adv Surg Tech A 2017;27:871–5.

[3].American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology 2012;16:248–73.

[4].Horlocker TT, Kopp SL, Pagnano MW, Hebl JR. Analgesia for total hip and knee arthroplasty: a multimodal pathway featuring peripheral nerve block. J Am Acad Orthop Surg 2006;4:26–35.

[5].Tan M, Siu-Chun Law L, Joo Gan T. Optimizing pain management to facilitate enhanced recovery after surgery pathways. J Can Anesth 2015;62:203–18.

[6].Dahl JB, Jeppesen IS, Jørgensen H, Wetterslev J, Møiniche S. Intraoperative and postoperative analgesic efficacy and adverse effects of intrathecal opioids in patients undergoing cesarean section with spinal anesthesia: a qualitative and quantitative systematic review of randomized controlled trials. Anesthesiology 1999;91:1919–27.

[7]. Sultan P, Halpern SH, Pushpanathan E, Patel S, Carvalho B. The effect of intrathecal morphine dose on outcomes after elective cesarean delivery: a meta-analysis. Anesth Analg 2016;123:154–64.

[8]. Abdallah FW, Halpern SH, Margarido CB. Transversus abdominis plane block for postoperative analgesia after caesarean delivery performed under spinal anaesthesia? A systematic review and meta-analysis. Br J Anaesth 2012;109:679–87.

[9].Mkontwana N, Novikova N. Oral analgesia for relieving post-caesarean pain. Cochrane Database Syst Rev 2015;3:CD010450.

[10].McDonnell NJ, Keating ML, Muchatuta NA, Pavy TJ, Paech MJ. Analgesia after caesarean delivery. Anaesth Intensive Care 2009;37: 539–51.

[11]. Aluri S, Wrench IJ. Enhanced recovery from obstetric surgery: a UK survey of practice. Int J Obstet Anesth 2014;23:157–60.

[12]. Spanjersberg WR, Reurings J, Keus F, van Laarhoven C. Fast track surgery versus conventional recovery strategies for colorectal surgery. Cochrane Database Syst Rev 2011;2: CD007635.