生命体征波动可用于脑外伤重症患者的疼痛评估吗?

Q2 Medicine
Pain Research and Treatment Pub Date : 2014-01-01 Epub Date: 2014-01-22 DOI:10.1155/2014/175794
Caroline Arbour, Manon Choinière, Jane Topolovec-Vranic, Carmen G Loiselle, Céline Gélinas
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引用次数: 0

摘要

背景。许多脑外伤(TBI)重症患者无法进行交流。虽然在对非语言人群进行疼痛评估时建议观察他们的行为,但在使用神经阻断剂的创伤性脑损伤患者中却无法检测到这些行为。研究目的本研究旨在验证在 TBI 重症患者中使用生命体征检测疼痛的有效性。方法。采用受试者内重复测量设计,观察受试者(N = 45)在无创血压:NIBP(非痛觉性)和翻身(痛觉性)两个程序之前(基线)、期间和之后 15 分钟的情况。每次评估均记录生命体征(如收缩压、舒张压、平均动脉压 (MAP)、心率 (HR)、呼吸频率 (RR)、毛细血管饱和度 (SpO2)、潮气末二氧化碳和颅内压 (ICP))。结果显示舒张压 (F = 6.087)、心率 (F = 3.566)、SpO2 (F = 5.740) 和 ICP (F = 3.776) 在不同的评估中均有显著波动(P < 0.05),但在两个过程中波动幅度相似。相反,RR 仅在翻身过程中增加(t = 3.933;P < 0.001),并且与参与者的自我报告相关。结论。本研究的结果支持之前的研究,即生命体征对疼痛检测没有特异性。虽然 RR 可作为危重症护理中的潜在疼痛指标,但仍需进一步研究,以支持其在不同 LOC 的创伤性脑损伤患者中的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can fluctuations in vital signs be used for pain assessment in critically ill patients with a traumatic brain injury?

Background. Many critically ill patients with a traumatic brain injury (TBI) are unable to communicate. While observation of behaviors is recommended for pain assessment in nonverbal populations, they are undetectable in TBI patients who are under the effects of neuroblocking agents. Aim. This study aimed to validate the use of vital signs for pain detection in critically ill TBI patients. Methods. Using a repeated measure within subject design, participants (N = 45) were observed for 1 minute before (baseline), during, and 15 minutes after two procedures: noninvasive blood pressure: NIBP (nonnociceptive) and turning (nociceptive). At each assessment, vital signs (e.g., systolic, diastolic, mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), capillary saturation (SpO2), end-tidal CO2, and intracranial pressure (ICP)) were recorded. Results. Significant fluctuations (P < 0.05) in diastolic (F = 6.087), HR (F = 3.566), SpO2 (F = 5.740), and ICP (F = 3.776) were found across assessments, but they were similar during both procedures. In contrast, RR was found to increase exclusively during turning (t = 3.933; P < 0.001) and was correlated to participants' self-report. Conclusions. Findings from this study support previous ones that vital signs are not specific for pain detection. While RR could be a potential pain indicator in critical care, further research is warranted to support its validity in TBI patients with different LOC.

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来源期刊
Pain Research and Treatment
Pain Research and Treatment Medicine-Anesthesiology and Pain Medicine
CiteScore
3.60
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