围术期音乐治疗对行全子宫切除术病人疼痛的影响.docVIP

围术期音乐治疗对行全子宫切除术病人疼痛的影响 【摘要】 目的探讨围术期音乐治疗对椎管内麻醉下行全子宫切除术者术后疼痛的影响。方法40例拟于蛛网膜下隙硬膜外间隙联合麻醉下行全子宫切除术者，随机分两组。音乐组于术前6 min至术毕持续听音乐；对照组只戴耳机，不听音乐。分别于术前、术毕和术后1 h检测血清IL6的浓度。记录病人术后0 h、1 h、2 h、3 h、7 h、11 h、15 h、19 h、24 h平卧时的疼痛评分、镇痛药用量、术后镇痛泵按压次数、恶心评分、疲倦评分、术后当晚的睡眠评分和24 h镇痛满意度（5级评分）。结果音乐组与对照组相比，术后1 h和2 h镇痛药用量和镇痛泵按压次数较少。两组病人24 h的疼痛评分存在明显的时间效应，干预因素与时间不存在交互作用。音乐组的睡眠较对照组好。两组其余各项指标比较差异无显著性。结论围术期音乐治疗可短暂缓解椎管内麻醉下行全子宫切除术者术后早期的疼痛，促进术后睡眠。 【关键词】 音乐治疗全子宫切除术围术期疼痛 Effects of Perioperative Music Therapy on Postoperative Pain of Patients Undergoing Hysterectomy REN Lingyun, FAN Ying. Dongfeng Hospital, Yunyang Medical College, Shiyan, 442000, China 【Abstract】 Objective To investigate the effect of perioperative exposure to music during intravertebral anesthesia on patients postoperative pain. Methods 40 ASAⅠ～Ⅱpatients were randomly assigned to listen to music or no music during the hysterectomy with intravertebral anesthesia. Serum IL6 was evaluated before, immediately after and 1h after surgery. 0 h、1 h、2 h、3 h、7 h、11 h、15 h、19 h、24 h after operation , pain scores（VAPS）at rest ,analgesic amount, PCA demand, nausea score(VANS),tiredness score (VATS) were recorded. Sleep sensation of operation night（VASS） and satisfaction about 24h analgesia were assessed(a 5grade scale). Results Compared with the control group, the music group required less analgesic and PCA 1h and 2h after operation. In all patients, 24h VAPS have a time effect（P0.01）,there was no interaction between intervention and time. Music group reported higher sleep sensation than the control.No differences were noted in other variables.Conclusions Perioperative music therapy has short-term effect on postoperative pain of patients undergoing hysterectomy with intravertebral anesthesia, and improves their sleeping. 【Key words】 Music therapy; Hysterectomy; Perioperative; Postoperative pain 研究显示，妇科手术病人术后即使使用了术后镇痛（PCA）泵，还有约1/4的人遭受中到重度疼痛，而且与其他手术病人相比，其急性疼痛更易导致慢性疼痛、睡眠不良和术后运动功能障碍［1］。镇痛理论认为辅助非药物的方法比单独使用药物更有效［1,2］。因此非药物的辅助方法对这类病人显得更为重要。关于音乐有效缓解全麻手术病人