ABSTRACT
Objective:To observe the analgesic effect and nursing intervention of pulse epidural controlled analgesia on uterine contraction pain after cesarean section.Methods:A total of 100 cases of parturient with patient-controlled epidural analgesia after elective cesarean section in Central Theater General Hospital of the Chinese People's Liberation Army from January to March 2019 were selected as study subjects, and 100 cases were divided into observation group and control group, each group of 50 cases, the control group used constant speed epidural patient-controlled analgesia, the observation group used pulse epidural patient-controlled analgesia. The analgesic effect of uterine contraction pain after cesarean section was observed, at the same time, the two groups conducted a simulation test, the speed, time and infiltration area of the pumping liquid were recorded, and the Visual Analogue Scale (VAS) scores of incision pain and uterine contraction pain were recorded at 6 h, 12 h, 24 h and 48 h postoperatively. VAS score of contraction pain after single press, Motor Block score of iatrogenic uterine pain were recorded on the postoperative day, the first day and the second day after operation.The times of additional dose compression by analgesia pump, the times of incomplete analgesia intervention, nausea and vomiting, skin itching and other adverse reactions were recorded within 2 days after operation.Results:The infiltration area at 1, 5 min were (130.00±14.14), (334.00±2.83) cm 2 in the observation group and (65.00±7.07), (137.50±3.54) cm 2 in the control group, there were significant differences between the two groups( t values were 5.814, 61.376, P< 0.05 or 0.01). VAS scores of incision pain at 6 h and 12 h after operation were (2.36±1.05) and (2.42±0.95) in the observation group and (3.52±1.09) and (3.16±1.25) in the control group, respectively, there were significant differences between the two groups( t values were 5.425, 3.331, P<0.01). VAS scores of uterine contraction pain at 6,12 and 24 hours after operation were (2.66±0.80), (2.23±0.68), (2.22±0.71) in the observation group and (5.14±1.05), (4.48±0.71), (3.36±0.80) in the control group, respectively, there were significant differences between the two groups( t values were 2.489, 2.008, 5.004, P<0.01 or 0.05).VAS scores of contraction pain after single press on the postoperative day, the first day and the second day after operation in the observation group were (2.66±0.80), (2.23±0.68), (2.22±0.71) in the observation group and (5.14±1.05), (4.48±0.71), (3.36±0.80) in the control group, respectively, there were significant differences between the two groups( t values were 13.296,15.536, 7.534, P<0.01). The times of pressing and intervention were (2.28±1.36) and (0.90±0.61) in the observation group and (4.62±1.61), (0.62±0.53) in the control group, respectively, there were significant differences between the two groups( t values were 7.847, 2.439, P<0.01 or 0.05). Maternal satisfaction score was (5.92±1.37) and (2.34±0.82) in the observation group and the control group, there was significant difference ( t value was 15.856, P<0.01).The incidence of adverse reactions such as lower limb numbness, nausea and vomiting and skin pruritus in the observation group were 2.00%(1/50), 4.00%(2/50) and 4.00%(2/50) respectively, which were lower than those in the control group 14.00%(7/50), 16.00%(8/50), 18.00%(9/50), the difference was statistically significant ( χ2 values were 4.759, 4.000, 5.005, P<0.05). Conclusions:The pulse epidural controlled analgesia can effectively reduce the uterine contraction pain after cesarean section, and the active nursing intervention can accelerate the postoperative recovery of parturient.
ABSTRACT
Objective To study the application effectiveness of healthcare failure modes and effects analysis before the secure transportation of post anesthesia care unit(PACU) patients. Methods A total of 689 general anesthesia post-operative patients who had been recovered in PACU and transported between January to December in 2015 by convenience sampling were divided into 2 groups to receive nursed by traditional method before transportation (contrast group, 346 cases) or nursed both with traditional way and healthcare failure modes and effects analysis method to analyze (observation group, 343 cases). The Medical Risk Priority Number (RPN), Status of Failure modes and satisfaction value of physicians and nurses were compared. Results The RPN value of observation group had been cut down from (229.00 ± 52.91) points to (57.14 ± 16.04) points, there was significant difference (t=7.58, P=0.01). The occurrence rate of failure mode of observation group was 2.62%(9/343), which was obviously lower than 19.36%(67/346) of contrast group, there was significant difference (χ2=49.19, P<0.01). The satisfaction rate of observation has improved significantly from 74.36%(58/78) to 93.59%(73/78), there was significant difference (χ2=10.72, P<0.01).Conclusions Healthcare failure modes and effects analysis management method could find out the failure mode of PACU patient before the secure transportation in time, could decrease the effect of failure mode and would continuously improve the quality of PACU nursing service .