ارزیابی درد ناشی از ساکشن لوله تراشه در بیماران تحت تنفس مکانیکی بستری در بخش مراقبت های ویژه کودکان

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار دانشکده پزشکی ،دانشگاه علوم پزشکی اصفهان

2 دکتری حرفه ای پزشکی عمومی، دانشگاه علوم پزشکی اصفهان

3 گروه اطفال دانشکده پزشکی دانشگاه علوم پزشکی اصفهان

چکیده

مقدمه: ارزیابی و کنترل درد بخش مهمی از درمان کودکان بستری در بخش مراقبت ویژه می­باشد و ارتباط بین درد و آثار فیزیولوژیک و روانی ناشی از آن به خوبی شناخته شده­است. هدف از این مطالعه ارزیابی درد ناشی از ساکشنلوله تراشه درکودکان تحت تنفس مکانیکیبستری در بخش مراقبت های ویژه می­باشد.
روش کار: این مطالعه روی 50کودک بستری در بخش مراقبت های ویژه که تحت تنفس مکانیکی بوده، انجام شد.در این بیماران درد بر اساس معیار درد FLACC و اندکس­های فیزیولوژِیک قبل و بعد از ساکشن لوله تراشه با رعایت پروتوکل استاندارد ساکشن مورد ارزیابی قرار­گرفت و بیماران بر اساس نمره کلی درد در یکی از 4 گروه1-بدون درد ، 2- درد خفیف ، 3- درد متوسط ،4- درد شدید قرار گرفتند.
نتایج: به طور خلاصه میانگین سنی بیماران  مورد مطالعه 34.44 ماه بوده­است و70% (35=n) جنس پسر داشته­اند.بیماریهای تنفسی 30% (n=15) شایعترین تشخیص اولیه بوده­است. بر­اساس معیار دردFLACC فراوانی و شدت درد پس از انجام ساکشن لوله تراشه افزایش داشته­است( P-value<0.05). ارتباط بین افزایش ضربان قلب، تنفس و فشار خون سیستولیک و دیاستولیک با افزایش فراوانی و نمره درد پس از ساکشن، معنادار است (P-value <0.001). هم­چنین، بیمارانی که نمره درد بالاتری داشته­اند دوز داروی آنالژریک کمتری به صورت انفوزیون مداوم دریافت کرده­­­بودند ( P-value<0.05).
نتیجه­گیری: ساکشن لوله تراشه یک مداخله دردناک می­باشد و بیماران به دنبال آن تحت دیسترس قرار می­گیرند. بنابراین روش­های ارزیابی درد و روش­های دارویی و غیردارویی جهت کنترل درد  ناشی از آن توصیه می­شود.

کلیدواژه‌ها

عنوان مقاله [English]

Evaluation of pain resulting from endotracheal suction in mechanically ventilated patients in pediatric intensive care unit

نویسندگان [English]

  • Sharareh Babaei 1
  • Mohammad Amin Sanati 2
  • Majid Keyvanfar 3
1 Assistant Professor, School of Medicine, Isfahan University of Medical Sciences
2 Mohammad Amin Sanati: Medical Doctor, Isfahan University of Medical Sciences
3 Assistant Professor, School of Medicine, Isfahan University of Medical Sciences, Isfahan. Iran
چکیده [English]

Introduction: Pain assessment and control are essential parts of the treatment of children admitted to the intensive care unit. Moreover, the connection between pain and its physiological/ psychological effects is important. This study aims to evaluate the pain caused by endotracheal tube suctioning in mechanically ventilated children admitted to the intensive care unit.
Materials and methods: This study was performed on 50 hospitalized children who were under mechanical ventilation. In these patients, the pain was assessed according to FLACC pain criteria and physiologic indices before and after endotracheal tube suctioning following the standard suction protocol. Patients were divided based on the overall pain score as no pain, mild pain, moderate pain, and severe pain.
 
 Results: In summary, the average age of the patients was approximately 34 months, and 70% (n = 35) were male. Respiratory diseases (30%, n =15) were the most common initial diagnosis. According to FLACC pain criteria, the frequency and severity of the pain increased after endotracheal tube suctioning (p-value <0.05). The relation between increasing pulse rate, respiration rate, and systolic/diastolic blood pressure with enhancing distribution and pain level after suction is meaningful (P-value <0.001). Also, the patients with higher pain scores received lower doses of analgesic drugs by continuous infusion (P-value <0.05).
    Conclusion: Endotracheal tube suctioning is a painful intervention and patients are distressed following it. Therefore, pain assessment methods and pharmacological and non-pharmacological methods to control the resulting pain are recommended.

کلیدواژه‌ها [English]

  • Pediatric
  • intensive care units
  • pain measurement
  • mechanical ventilation

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 64، شماره 1
فروردین و اردیبهشت 1400
صفحه 2362-2375

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