| [Purpose]To explore a safe and effective mode of postoperative analgesia,to reduce the degree of postoperative pain after the second cesarean section,to enhance the comfort level after the operation,to promote the rapid recovery after the operation,and to improve the quality of obstetric care.[Methods]A total of 178 women in our hospital from July 2018 to May 2019 were selected and randomly divided into experimental group(89 cases)and control group(89 cases)by random number table method.Preoperative venous access was opened,intravenous indwelling needle was reserved,postoperative analgesia pump was connected,infusion rate was 2ml/h,single pressure dose was 0.5ml,locking time was 15min.The control group was treated with single-mode Analgesia,namely Patient Controlled Analgesia(PCA).It is a analgesic method for patients to control the amount of opioid by automatic infusion device.Clinically,it is referred to as the analgesic pump.The formula of the analgesic pump in our hospital is:250mg flurbiprofen was mixed with 60mg butofino tartaric acid and 10mg tropisetron.the total volume is 100ml.On this basis,the experimental group adopted multi-mode analgesia,including Acute pain service model,psychological counseling mode,combined drug analgesia mode and pre-analgesia mode.Clinical Symptom Check list-90(scl-90)was used to investigate the mental health status of patients in the two groups before and after intervention.Pain score with Visual Analogue Scale Scale(Visual Analogue Scale,VAS),Numeric Rating Scale(Numeric Rating Scale,NRS)or facebook Pain Rating Scale(Faces Pain Rating Scale,FPRS),with reference to the WHO Pain grading assessment of Pain intensity,the two groups after ChanFuShu levels including O(no Pain),1(mild Pain),2(moderate Pain),3(severe Pain);The Houston pain questionnaire was used to investigate the postoperative pain control level of the two groups.The first time of getting out of bed,exhaust time,first lactation time,hospital stay and the incidence of complications were recorded and compared between the two groups.Pittsburgh sleep quality index(PSQI)was used to evaluate the sleep quality before and after intervention.SPSS25.0 was used to calculate the data,Wilcoxon rank sum test was used for ranking data,measurement data were represented by(x±S);lsd-t test was used,counting data were represented by[n(%)];x2 test was used,P<0.05 was used for data difference.[Statistical of Results]1.There was no statistically significant difference between the two groups in maternal general information including age,gestational age and body quality.2.There was no significant difference in the scores of 9 dimensions(depression,anxiety,hostility,terror,paranoia,somatization,obsessiveness,psychosis,interpersonal sensitivity)in scl-90 between the two groups before intervention(P>0.05).The scores of 9 dimensions of scl-90 after intervention in the two groups were significantly lower than those before intervention(P<0.05),and the scores of 9 dimensions of scl-90 after intervention in the experimental group were significantly lower than those in the control group(P<0.05).3.The pain level of the experimental group was significantly less than that of the control group at 24 hours after the operation(P<0.05).The scores of 3 dimensions(pain experience,influence on mood,influence on body and daily life)in the experimental group were higher than those in the control group(P<0.05),and the scores of 2 dimensions(pain control effect and satisfaction with pain education)in the experimental group were lower than those in the control group(P<0.05).4.The first time of getting out of bed,exhaust time,first lactation time and hospital stay of pregnant women in the experimental group were significantly shorter than those in the control group(P<0.05).The incidence of postoperative complications in the experimental group was significantly lower than that in the control group(P<0.05).5.There was no significant difference in PSQI score between the two groups before intervention(P>0.05);The PSQI score after intervention in the two groups was significantly lower than that before intervention(P<0.05),and the PSQI score after intervention in the experimental group was significantly lower than that in the control group(P<0.05).[Conclusion]Multi-modal analgesia nursing intervention can effectively improve the level of pain control of women in the second cesarean section,with the following effect of reducing childbirth and Reduce the stress response to pain,improving the mental state after maternity,improving the negative emotions,decreasing postoperative complications,improving maternal sleep quality as well as their maternal physical and mental comfort,and this will promote the recovery rapidly after surgery.With good intervention effect and the highly.satisfaction with pain control,Multi-modal analgesia nursing intervention is worth to be recommend. |
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