针刺超前镇痛对腹腔镜胆囊切除术后镇痛的影响  

The influence of preemptive analgesia applied by electroacupuncture on postoperative analgesia after laparoscopic cholecystectomy

作　　者：吴昱[1] 袁军[1] 丰新民[1] 

机构地区：[1]湖北省武汉市第一医院麻醉科,湖北武汉430022

出　　处：《中国内镜杂志》2012年第6期585-588,共4页China Journal of Endoscopy

基　　金：武汉市卫生局中医药中西医结合科研课题:武卫【2007】43号

摘　　要：目的观察针刺超前镇痛对腹腔镜胆囊切除术患者围术期镇痛效果的影响。方法将拟行腹腔镜胆囊切除术患者60例随机分为3组,每组20例。A组针刺辅助吸入麻醉,术后经静脉患者自控镇痛(PCIA);B组吸入麻醉,术后针刺辅助PCIA;C组吸入麻醉,术后PCIA。采用视觉模拟评分法(VAS)记录平静及活动时VAS评分、平静及活动时PCA按压次数(Demand)与实进次数(Delivery)比值(D/D比值),据此推算平静及活动时额外芬太尼用量。结果镇痛效果及用药情况:VAS评分A、B组各时间点明显低于C组(P<0.05),A组与B组比较差异无显著性(P>0.05);首24h额外芬太尼用量C组最多,A组最少,A组与B、C组相比差异有显著性(P<0.05)。D/D比值在0～2范围内的病例数A组最多,C组最少(P<0.01),B组与C组相比差异有显著性(P<0.05)。结论麻醉前30min针刺能显著降低术后患者对疼痛的敏感性,增强术后芬太尼镇痛效果,有效地减少芬太尼的用量,具有一定的超前镇痛效果。[ Objective ] To observe the influence of preemptive analgesia applied by electroacupuncture on post- operative analgesia after laparoscopic cholecystectomy （LC） and find the clinical basis of electroacupuncture having postoperative analgesia effect. [ Methods ] Sixty patients underwent LC were randomly divided into three groups. The patients in the group A （n =20） received electroacupuncture before Inhaled anesthesia; the patients in the group B （n =20） received inhaled anesthesia and electroacupuncture after LC; there were no electroacupuncture in the group C （n =20）. All the patients were given patient-controlled intravenous analgesia （PCIA）. Visual analogue scale （VAS）, press times of PCIA, demand/delivery ratio （D/D） in rest and activity state in all the patients were observed and ac- cording to these to calculate the demand of extra dosage of fentanyl. [ Results ] VAS in the group A and B were low- er than in the group C （P 〈0.05）, and there were no different in the group A and in the group B （P 〉0.05）. The most demand of extra dosage of fentanyl were in the group C and the least demand were in the group A, compared with the group B and C, there were significant difference in the group A （P 〉0.05）. There were the most cases of D/D ra- tio in 0~2 in the group A, and the least in the group C, there were significant difference in the group B and in the group C （P 〈0.05）. [ Conclusion ] Giving electroacupuneture 30min before anesthesia can significantly decrease sen- sitivity of patients＂ pain after operation, increase the postoperative analgesia effect of fentanyl, reduce the demand of fentanyl, have the effect of preemptive analgesia.

关 键 词：电刺激 超前镇痛 腹腔镜胆囊切除术 

分 类 号：R246.2[医药卫生—针灸推拿学]