PCEA对急性疼痛患者糖代谢的影响  

Effects of patient-controlled epidural analgesia on glucose metabolism in patients with acute pain

作　　者：梁本初 彭国庆[1] 吴在荣 郑威伟[1] 

机构地区：[1]句容市人民医院麻醉科,212400

出　　处：《江苏医药》2009年第10期1140-1141,共2页Jiangsu Medical Journal

摘　　要：目的研究病人自控硬膜外镇痛(PCEA)对急性疼痛患者糖代谢的影响。方法急性骨盆、下肢外伤患者69例随机分为两组。A组36例,入院后仅以注射吗啡或哌替啶止痛;B组33例,入院后即行PCEA。入院后即时和伤后第1、3、6天抽血检测空腹血糖(FBG)、胰岛素(Ins)及糖基化血红蛋白(HbA-1c),计算胰岛素作用指数(IAI)。结果两组术前HbA-1c无统计学差异(P>0.05)。B组疼痛强度明显小于A组(P<0.05)。B组在外伤后的第1、3、6天FBG和Ins明显低于A组,而IAI明显高于A组(P<0.01)。结论及早实施PCEA比传统镇痛方法有效地改善急性疼痛患者的糖代谢紊乱。Objective To study the effects of patienvcontrolled epidural analgesia（PCEA） on glucose metabolism in patients with acute pain. Methods Sixty patients with acute pain after trauma in the pelvic or lower extremity were randomly divided into two groups. Soon after admission, the patients in group A were given conventional pain relieve with morphine or pethidine injection and those in group B were given PCEA with 100 ml analgesic solution consisting of fentanyl 0.6 mg, 0. 125% bupivacaine and ondansetron 8 mg. The fasting blood glucose （FBG）, insulin （Ins） and glycosylated hemoglobin（HbA-1c） were measured soon after admission,on the 1st,3rd and 6th day thenafter. The insulin action index（IAI） was calculated. Results There was no significant difference in GhA-1c between two groups （P〉0.05）. VAS scores were less in group B than those in group A （P〈0.05）. Compared with group A,FBG and Ins were lower, but IAI was higher in group B on the 1st, 3rd and 6th day （P〈0. 01）. Conclusion Compared with the conventional pain relieve with morphine or pethidine injection, PCEA as early as possible is better in improving the disturbance of glucose metabolism in patients with acute pain.

关 键 词：急性疼痛 病人自控硬膜外镇痛 糖代谢 

分 类 号：R614[医药卫生—麻醉学]