病人自控镇痛技术在介入治疗术中的应用  

Application of Patient Controlled-analgesia in Interventional Therapy

作　　者：陈大琳[1] 李江[1] 潘卫州[1] 金华[1] 薄云[1] 李艳华[1] 

机构地区：[1]云南省第一人民医院麻醉科,云南昆明650032

出　　处：《昆明医学院学报》2012年第7期67-71,共5页Journal of Kunming Medical College

基　　金：云南省应用基础研究基金资助项目(2008ZC082M)

摘　　要：目的研究不同麻醉方式应用于介入手术患者的安全性和有效性.方法将90例ASAⅠ～Ш级拟行介入治疗术患者分为3组,每组30例.对照组(C组)行局部麻醉;丙泊酚靶控输注组(TCI组)以靶控输注技术持续静脉输注丙泊酚,血浆靶浓度为5～7μg/mL;瑞芬太尼病人自控镇痛泵输注组(PCA组)以PCA模式静脉输注瑞芬太尼.记录镇痛效果、镜检情况、生命体征、不良反应等.结果 TCI组和PCA组VAS评分低于C组(P<0.01),镜检成功率及患者满意度高于C组(P<0.01);与C组和TCI组比较,PCA组呼吸、循环于各时点变化无差异(P>0.05),不良反应发生率低(P<0.05),检查者满意度高(P<0.05).结论瑞芬太尼PCA技术可满足介入治疗术患者镇痛需求,安全性好,值得在临床推广应用.Objective To compare the safety and feasibility of different analgesic modes for interventional therapy. Methods 90 candidates with ASA I -II[ undergoing interventional therapy were divided into three groups： group C （n = 30）, group TCI （n = 30） and group PCA （n = 30）. In group C, patients underwent the therapy with local anesthesia; the target controlled infusion group （TCI） was given with propofol maintained at 5-7 t^g/mJ; in group PCA, remifentanil was infused by patient controlled analgesia （PCA） system. Antalgic effect, operative condition, vital signs, side effects were recorded. Results Compared with group C, analgesic effect in group TCI and PCA was better （P 〈 0.01） , success ratios of interventional therapy and satisfactory degree of patients were higher （P 〈 0.01 ）. Compared with group C and TCI, in group PCA, respiration and circulation changed less at different time points （P 〈 0.05） , side effects were less （P 〈 0.05） , and satisfactory degree of operators was higher （P 〈 0.05）. Conclusion PCA with remifentanil for interventional therapy has good analgesic effect and safety, so is worth extending in clinic practice.

关 键 词：病人自控镇痛 介入治疗术 瑞芬太尼 丙泊酚 

分 类 号：R338[医药卫生—人体生理学] R28[医药卫生—基础医学]