Optimization of postoperative pain management for neurosurgical ICU patients guided by the enhanced recovery after surgery (ERAS) concept
加速康复外科（ERAS）理念指导下脑外ICU患者术后疼痛管理的优化

摘要

目的 探讨加速康复外科（enhanced recovery after surgery，ERSA）理念指导下优化脑外ICU患者术后疼痛管理的效果。方法 选取2024年3月至2025年3月在我院神经外科ICU行择期开颅手术患者60例，采用随机数字表法分为两组，对照组采用常规疼痛管理模式，观察组采用基于ERAS理念的优化疼痛管理模式。比较两组疼痛评分、不良反应发生率、机械通气时间与ICU住院时间及生命体征。结果 观察组术后24h、48h、72h NRS评分均低于对照组；相较于对照组，观察组总不良反应发生率更低；观察组机械通气时间与ICU住院时间短于对照组；观察组术后6h、12h的心率和平均动脉压低于对照组（P＜0.05）。结论 基于ERAS理念的优化疼痛管理模式能有效减轻脑外ICU患者术后疼痛，减少镇痛药物用量及不良反应，缩短ICU停留时间，值得推广。

Abstract

Objective To explore the effectiveness of optimizing postoperative pain management for ICU patients undergoing brain surgery under the guidance of the concept of enhanced recovery after surgery.
Methods Sixty patients who underwent elective craniotomy surgery in our neurosurgery ICU from March 2024 to March 2025 were selected and randomly divided into two groups using a random number table method. The control group received conventional pain management mode, while the observation group received optimized pain management mode based on ERAS concept. Compare the pain scores, incidence of adverse reactions, duration of mechanical ventilation, ICU stay, and vital signs between two groups.
Results The NRS scores of the observation group were lower than those of the control group at 24 hours, 48 hours, and 72 hours after surgery; Compared to the control group, the observation group had a lower overall incidence of adverse reactions; The observation group had a shorter duration of mechanical ventilation and ICU stay compared to the control group; The heart rate and mean arterial pressure of the observation group were lower than those of the control group at 6 and 12 hours after surgery (P<0.05).
Conclusion   The optimized pain management model based on ERAS concept can effectively alleviate postoperative pain in extracranial ICU patients, reduce the dosage and adverse reactions of analgesic drugs, shorten ICU stay time, and is worth promoting.