Analysis of nursing intervention on pain relieving after ambulatory laparoscopic cholecystectomy_West China Medical Journal

Authors：

DU Jiaojiao , SONG Yinghan , LI Shihan , ZHANG Yuchen , MA Hongsheng ,  DAI Yan

Day Surgery Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DAI Yan, Email: 1846703501@qq.com

Keywords：

Nursing intervention; Day surgery; Laparoscopic cholecystectomy; Pain

DOI：

10.7507/1002-0179.201710091

Video：

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Objective To analyze the clinical effect of individualized pain nursing intervention on the pain relieving after ambulatory laparoscopic cholecystectomy (LC) . Methods From March to June 2017, a total of 180 ambulatory LC patients were selected and randomly asigned into the control group and the intervention group with 90 cases in each group. Parecoxib sodium (40 mg) was preoperatively administrated half an hour before the surgery to the patients in both of the two groups. The patients in the control group were treated with routine nursing intervention, while the ones in the intervention group were given individualized pain nursing interventions, including regular pain assessment, preoperative pain health guidance, enhanced education for pain related knowledge, and following the nursing theory of enhanced recovery after surgery. Visual Analogue Scale (VAS) was used to measure the degree of postoperative pain, and the data of dormant pain were collected. Results There was no significant difference between the two groups in VAS one hour after the operation (P>0.05); the VAS scores 2, 6 and 12 hours after the operation gradually decreased in the two groups (P<0.05), and the scores of patients in the intervention group were much lower than those in the control group (P<0.05). The time of pain relieving in the intervention group and the control group was (3.25±1.72) and (5.39±2.06) hours, respectively, and the difference was statistically significant (P<0.05). The incidence of dormant pain in the intervention group (12.2%) was lower than that in the control group (33.3%), and the difference was statistically significant (P<0.05). Conclusion Individualized pain nursing interventions can effectively alleviate the postoperative pain and improve the quality of sleep in ambulatory LC patients.

Citation： DU Jiaojiao, SONG Yinghan, LI Shihan, ZHANG Yuchen, MA Hongsheng, DAI Yan. Analysis of nursing intervention on pain relieving after ambulatory laparoscopic cholecystectomy. West China Medical Journal, 2017, 32(11): 1667-1670. doi: 10.7507/1002-0179.201710091 Copy

1.	姜华, 杨晋东. 羟考酮联合帕瑞昔布钠在腹腔镜胆囊切除术后自控静脉镇痛中的应用. 山东医药, 2017, 57(10): 62-64.
2.	臧安童, 席小明, 刘军. 腹腔镜胆囊切除不过夜日间手术 78 例临床分析. 中国微创外科杂志, 2016, 16(9): 780-783.
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4.	戴燕, 彭小华. 快速康复理念在日间腹腔镜胆囊切除术中的应用. 华西医学, 2011, 26(8): 1234-1235.
5.	苏喆, 徐珂嘉, 陶伟民, 等. 快速康复外科理论指导下右美托咪啶术后镇痛在腹腔镜胆囊切除术中的应用. 山东医药, 2016, 56(34): 48-50.
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8.	刘洋, 马洪升, 李志超, 等. 5520 例日间手术的安全和质量评价. 中国普外基础与临床杂志, 2015, 22(12): 1477-1481.
9.	胡建, 许建峰, 刘耿, 等. 不同剂量羟考酮术前用药对腹腔镜胆囊切除术后疼痛及炎症细胞因子的影响. 临床麻醉学杂志, 2015, 31(10): 941-944.
10.	殷文渊, 王苑, 沈莉丽, 等. 腹横筋膜阻滞联合帕瑞昔布钠对日间腹腔镜胆囊切除术后镇痛效果的观察. 河北医学, 2016, 22(6): 886-889.
11.	周碧英, 李红. 护理干预对腹腔镜胆囊切除术后疼痛及胃肠功能的影响. 河北医学, 2015, 21(6): 1012-1015.
12.	王辉, 王坚. 加速康复外科理念指导下的日间腹腔镜胆囊切除术 1 400 例分析. 肝胆胰外科杂志, 2017, 29(1): 6-9.
13.	戴燕, 殷宇. 日间腹腔镜胆囊切除术后不良反应分类及护理. 华西医学, 2015, 30(5): 835-836.
14.	廖作富, 陈中皓, 谢江, 等. 快速康复对腹腔镜胆囊切除术患者的临床效果研究. 医学临床研究, 2017, 34(2): 324-326.
15.	杨月. 腹腔镜胆囊切除术 82 例早期护理干预效果观察. 齐鲁护理杂志, 2016, 22(6): 85-87.

1. 姜华, 杨晋东. 羟考酮联合帕瑞昔布钠在腹腔镜胆囊切除术后自控静脉镇痛中的应用. 山东医药, 2017, 57(10): 62-64.
2. 臧安童, 席小明, 刘军. 腹腔镜胆囊切除不过夜日间手术 78 例临床分析. 中国微创外科杂志, 2016, 16(9): 780-783.
3. 李志超, 王煜, 王小成, 等. 基于快速康复外科理念的疼痛管理模式在日间腹腔镜胆囊切除术的应用. 华西医学, 2015, 30(5): 804-807.
4. 戴燕, 彭小华. 快速康复理念在日间腹腔镜胆囊切除术中的应用. 华西医学, 2011, 26(8): 1234-1235.
5. 苏喆, 徐珂嘉, 陶伟民, 等. 快速康复外科理论指导下右美托咪啶术后镇痛在腹腔镜胆囊切除术中的应用. 山东医药, 2016, 56(34): 48-50.
6. Andersen LP, Kücükakin B, Werner MU, et al. Absence of analgesic effect of intravenous melatonin administration during daytime after laparoscopic cholecystectomy: a randomized trial. J Clin Anesth, 2014, 26(7):545-550.
7. Philip BK. Day care surgery: the United States model of health care. Ambul Surg, 2012, 17(4): 81-82.
8. 刘洋, 马洪升, 李志超, 等. 5520 例日间手术的安全和质量评价. 中国普外基础与临床杂志, 2015, 22(12): 1477-1481.
9. 胡建, 许建峰, 刘耿, 等. 不同剂量羟考酮术前用药对腹腔镜胆囊切除术后疼痛及炎症细胞因子的影响. 临床麻醉学杂志, 2015, 31(10): 941-944.
10. 殷文渊, 王苑, 沈莉丽, 等. 腹横筋膜阻滞联合帕瑞昔布钠对日间腹腔镜胆囊切除术后镇痛效果的观察. 河北医学, 2016, 22(6): 886-889.
11. 周碧英, 李红. 护理干预对腹腔镜胆囊切除术后疼痛及胃肠功能的影响. 河北医学, 2015, 21(6): 1012-1015.
12. 王辉, 王坚. 加速康复外科理念指导下的日间腹腔镜胆囊切除术 1 400 例分析. 肝胆胰外科杂志, 2017, 29(1): 6-9.
13. 戴燕, 殷宇. 日间腹腔镜胆囊切除术后不良反应分类及护理. 华西医学, 2015, 30(5): 835-836.
14. 廖作富, 陈中皓, 谢江, 等. 快速康复对腹腔镜胆囊切除术患者的临床效果研究. 医学临床研究, 2017, 34(2): 324-326.
15. 杨月. 腹腔镜胆囊切除术 82 例早期护理干预效果观察. 齐鲁护理杂志, 2016, 22(6): 85-87.

West China Medical Journal

Analysis of nursing intervention on pain relieving after ambulatory laparoscopic cholecystectomy

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