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| Application effect of the concept of enhanced recovery after surgery based on standardized pain management in the intervention of early out-of-bed for elderly patients with hip fracture |
| DING Liumin1 GAO Jing2 XU Peilan3 |
1.Department of Nursing, Xinjiang Uygur Autonomous Region People’s Hospital, Xinjiang Uygur Autonomous Region, Urumqi 830000, China;
2.Medical and Health Service Management Guidance Center Institute Management Section, Xinjiang Uygur Autonomous Region, Urumqi 830000, China; 3.Department of Scientific Research and Education Health Commission of Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi 830000, China |
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Abstract Objective To explore the clinical application effect of enhanced recovery after surgery based on standardized pain management in early out-of-bed activities of elderly patients with hip fracture. Methods According to the principle of randomized controlled study, 84 elderly patients with hip fracture peformed artificial hip replacement in Xinjiang Uygur Autonomous Region People’s Hospital from January 2019 to December 2020 were selected and divided into control group and observation group by random number table method, with 42 cases in each group. The control group was given standardized pain management nursing, and the observation group was given the early out-of-bed intervention of concept of enhanced recovery after surgery based on standardized pain management in the control group. The visual analogue scores before operation, the day after surgery, the 1st, 3rd, 5th day, and the one week after surgery; the changes of hip function score before operation, two weeks, one month and three months after operation; first time out of bed, mean length of hospital stay, satisfaction and complications were compared between the two groups. Results The pain scores of the two groups before operation, postoperative the 1st, 3rd, 5th and one week after operation were compared. The overall analysis showed that there were statistically significant differences in the comparison between groups, time points and interaction (P ＜ 0.05). There were statistically significant differences between the two groups at each time point (P ＜ 0.05), and the visual analogue scores of the observation group were lower than those of the control group at each time point after surgery, and the differences were statistically significant (P ＜ 0.05). The hip function scores of the two groups before operation, two weeks, one month, and three months after operation were compared. The overall analysis showed that there were statistically significant differences in the comparison between groups, time points and interaction (P ＜ 0.05). Further pairwise comparison showed that there were significant differences between the two groups at each time point(P ＜ 0.05), the change of hip function scores at each time point after surgery in the observation group was higher than that in the control group, and the differences were statistically significant(P ＜ 0.05). The first time out of bed and the average length of hospital stay in the observation group were lower than those in the control group, the satisfaction was higher than that in the control group, and the total incidence of complications such as constipation, pulmonary infection, urinary tract infection and deep vein thrombosis of lower limbs was lower than that in the control group, and the differences were statistically significant (P ＜ 0.05). Conclusion Enhanced recovery after surgery based on pain management can reduce pain in elderly patients with hip fracture, shorten the first time of getting out of bed, improve hip function, reduce the incidence of postoperative complications, and promote early rehabilitation after joint replacement.
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