中国临床药学杂志

目的 构建临床药师参与胸外科术后急性疼痛管理的工作模式，并对其应用效果进行评价。方法 选取2024年3至7月在胸外科住院并采用电视辅助胸腔镜手术行肺部切除的患者103例，随机分为对照组（n=50）和试验组（n=53），对照组予常规术后疼痛管理，试验组予临床药师参与胸外科术后急性疼痛管理的工作模式。比较2组术后6、24和48 h静息时和活动时疼痛程度和爆发痛发生情况，评估患者使用镇痛药物的依从性。结果 比较2组术后6 h静息时和活动时的疼痛数字评分法（NRS）评分，差异无统计学意义（P > 0.05）；试验组术后24和48 h静息时和活动时NRS评分均低于对照组，差异有统计学意义（P<0.05）。试验组术后爆发痛发生率低于对照组，使用镇痛药物的依从性优于对照组，差异均有统计学意义（P<0.05）。结论 构建的临床药师参与胸外科术后急性疼痛管理的工作模式，能够缓解胸外科患者术后疼痛程度，降低爆发痛发生率，提高患者依从性，进而改善患者预后，值得推广。

AIM To develop a clinical pharmacist-involved model for acute postoperative pain management in thoracic surgery and evaluate its application effect. METHODS A total of 103 patients hospitalized in the department of thoracic surgery between March and July 2024, who underwent elective video-assisted thoracoscopic surgery(VATS) for lung resection, were enrolled and randomly assigned to either a control group(n=50) or an intervention group(n=53). The control group received conventional postoperative pain management, while the experimental group received acute postoperative pain management with the involvement of clinical pharmacists. The postoperative pain intensity in both the resting and active states, as well as the occurrence of breakthrough pain, was compared between 2 groups at 6 h, 24 h, and 48 h after surgery. Additionally, patient compliance with analgesic medication use was evaluated. RESULTS No statistically significant difference was observed in the numerical rating scale(NRS) scores in both the resting and active states at 6 h postoperatively between 2 groups(P > 0.05). However, the intervention group demonstrated significantly lower NRS scores at both 24 h and 48 h postoperatively, in both the resting and active states, compared to the control group(P < 0.05). Furthermore, the incidence of breakthrough pain was significantly lower, and compliance with analgesic medication was significantly better in the intervention group than in the control group, with all differences being statistically significant(P < 0.05). CONCLUSION The work model constructed for clinical pharmacists in the management of acute postoperative pain in thoracic surgery effectively alleviates pain intensity, reduces the incidence of breakthrough pain, and enhances patient compliance. Consequently, it contributes to improving patient outcomes and is deemed worthy of widespread adoption.