The Current Situation Of Acute Pain Management And The Correlation Between Pain And Stress Response In Patients With Traumatic Fracture Before Operation

【Objective】To investigate the current situation of preoperative acute pain management in patients with traumatic fracture by medical staff,and analyze the correlation between preoperative acute pain and stress response in patients with traumatic fracture,so as to provide basis for patients to solve the problem of preoperative acute pain management.【Method】From February 2019 to July 2019,242 patients with traumatic fracture were selected from Hainan Hospital Affiliated to Hainan Medical College,the First Affiliated Hospital of Hainan Medical College,the Second Affiliated Hospital of Hainan Medical College and the emergency department of Haikou People’s hospital.The current situation of preoperative acute pain management of patients with traumatic fracture was understood through the self-designed questionnaire on preoperative pain management of patients with traumatic fracture The severity of pain was assessed by NRs when the patients entered the emergency department and 1H before operation;the anxiety state was assessed by HAMA;the changes of heart rate and blood pressure(map)were recorded,and the levels of angiotension Ⅱ and glucagon were measured by venous blood to analyze the patients with traumatic fracture The effect of pain management on stress response of patients.All the collected data were analyzed by spss22.0 software.【Results】1.Current situation of patient pain managementIn this study,242 patients were included,42.98% of them used non drug analgesia,20.25% of them used drug analgesia,32.23% of them did not take any analgesic measures.It was found that only 12.40% of patients were informed of the importance of pain management,33.88% of patients had received pain education,62.81% of patients did not know about pain related knowledge.The average pain score of the patients in the emergency department was(8.57 ? 1.21),and the average pain score of the patients in the first hour before operation was(9.05 ? 0.95).There was no significant change in the distribution of pain degree between the patients in the emergency department and the patients in the first hour before operation,and the difference was not statistically significant((49)(29)0.05).The scores of the influence of pain on emotion,walking ability,interpersonal relationship,sleep and other aspects were(7.53 ? 0.68),(7.21 ? 0.53),and(8.04 ? 0.33)and(8.10 ? 0.48),pain has a serious impact on patients’ mood and sleep;patients’ satisfaction survey on preoperative pain management shows that patients with satisfaction or above accounted for a relatively small proportion(23.96%),and 52.48% of patients are still dissatisfied with preoperative pain management..There was no significant difference in the preoperative pain score of 104 patients who took non drug analgesia measures and 78 patients who did not take any analgesia measures(P(27)0.05).The pain score of the patients who took drug analgesia,non drug analgesia and drug analgesia at the same time at one hour before operation was lower than that of the patients who entered the emergency department,the difference was statistically significant(Gender,age,occupational status,trauma history,preoperative pain health education,whether to change other pain relief measures after taking pain relief measures,whether to understand the pain related knowledge before operation had significant statistical differences in the average preoperative pain score(P(27)0.05)2.The effect of pain management on stress responseThe blood pressure and heart rate of patients with drug analgesia and non drug and drug analgesia were significantly lower than those in emergency department(P(27)0.05).The higher the pain score,the higher the HAMA score,angiotensinⅡ,glucagon,blood pressure and heart rate.The difference of each index was statistically significant(P(27)0.05).【Conclusion】1.The patients with traumatic fracture are generally in the level of moderate and severe pain before operation,which seriously affects their sleep and mood.2.At present,the pain management measures taken by the clinical staff for the patients with traumatic fracture are single,and the patients’ satisfaction for pain management is low.3.Poor preoperative pain management of patients with traumatic fracture will lead to stress reactions such as changes in neuroendocrine function.Through effective pain management of patients with traumatic fracture,it can effectively reduce pain stimulation,inhibit the levels of angiotension Ⅱ and glucagon,and reduce the degree of stress response of patients with traumatic fracture.4.Strengthen the attention of clinical medical staff on pain management,correctly use drug analgesia and non drug analgesia for pain management,and strengthen psychological intervention and preoperative pain health education for patients with traumatic fracture.