• 作者： 梁靜祝; 高紀惠
• 作者服務機構： 國立台灣大學醫學院護理學系
• 中文摘要： 手術前後病人會因緊張、害怕造成肌肉緊張，增加手衛後傷口疼痛。本研究以實驗性研究決來探討運用肌肉鬆弛伕對於減輕手術後疼痛的效用。選取30名因罹息肝膽結石及慢性十二指腸潰瘍而接受腹部手衛的病人，配對分為實驗組及控制組。手術前教導實驗組病人練習運用肌肉鬆弛法，但兩組病人均教以必須的衛教，以減輕他們對於手術的恐懼。以手術當天下午4時至10時為評估實驗組病人運用肌肉鬆弛汰前後疼痛反應的時間。本文以Chamber及Price設計之疼痛反應表測定病人主觀及客觀疼痛反應。並以同樣方式測量記錄兩組病人手術當天下午10時，手術後24小時，48小時之主觀及客觀疼痛反應；記錄兩組病人於手術後五天內要求止痛劑的次數以及手術後首次下床行走的時間，以茲比較。 研究結果顯示：(1)實驗組病人在手術當天下午4時至10時傷口疼痛時運用肌肉鬆弛法可使疼痛反應顯著降低。(2)於手術當天下午4時至10時問運用肌肉鬆弛汰次數多少與手術當天下午10時以後病人疼痛反應無顯著性相關。(s)運用肌肉鬆弛法的實驗組病人在手術當天下午10時，手術後第24小時，疼痛反應均比控制組顯著地降低，但在手術後第48小時之疼痛反應兩組無統計學上差異。(4)實驗組病人在手術結束後至當天下午10時之問要求止痛劑的次數及人數均比控制組少很多，但手術當天下午10時以後兩組病人要求止痛劑的次數並無明顯差異。手術後五天內要求止痛劑的次數，實驗組比控制組顯著地減少。(5)手術後首次下床時問實驗組亦比控制組顯著提早。(6)司性別、年齡、社會階層的不同並不影響運用肌肉鬆弛法的效果。
• 英文摘要： The experimental study is to investigatethe effect of muscle relaxation decreasingpostoperative pain. 30 patients accepted majorabdominal surgery were selected and pairedinto two groups：experimental and controlgroup. The experimental group was taughtto master muscle relaxation technique beforeoperation. Chamber and Price Pain RatingScale is used to measure the subjective andobjective pain reaction of the patient. Datawas collected before and after the experi-mental ones applied muscle relaxationtechnique from 4 to 10 PM of the operativeday. Both groups were examed and comparedthe pain reaction at lOPM of the operativeday，and at the 24th hour, the 48th hourafter operation，we record the amount ofanalgesics used in the first 5 days afteroperation, and the first ambulating timepostoperation of both groups for comparison. The results demonstrated significant differ-ences in three stages：pain reaction before andafter the usage of muscle relaxation technique；pain reaction at lOPM of the operative day；andat the 24th hour postoperation. The differencebetween the amount of analgesics usage andfirst ambulation time is also significant. Theeffect of muscle relaxation technique was notinfluenced by sex, age or social status. Basedon this study, the investigator suggeststhat nurses should teach preoperative patientsmuscle relaxation technique for decreasingpostoperative pain.
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