全麻与腰麻剖宫产术后患者静脉自控镇痛疗效比较  

A comparison of postoperative pain control by patient-controlled intravenous analgesia after spinal versus general anesthesia in cesarean sections

作　　者：汪辉德[1] 李竹冰[2] 尤俊谦 施娴[2] 刘琴[2] 杨晏[2] 钟庆[1] 

机构地区：[1]四川省简阳市人民医院麻醉科,四川简阳641400 [2]四川省简阳市人民医院产科,四川简阳641400

出　　处：《实用医院临床杂志》2013年第4期142-144,共3页Practical Journal of Clinical Medicine

基　　金：资阳市科技局2011年科研课题(编号:资科A020333)

摘　　要：目的比较全麻与腰麻剖宫产术后患者静脉自控镇痛(patient controlled intravenous analgesia,PCIA)的疗效。方法实施剖宫产(cesarean section,CS)并且愿意接受术后镇痛的产妇120例,分为全麻组与腰麻组各60例,术毕均接静脉电子镇痛泵。观察两组48 h内各随访时点的视觉模拟评分(VAS)、镇痛泵使用时间、按压次数(D1)、实际进入次数(D2)及产妇满意度评分。结果在术后1～2、4、16及24 h时间点,腰麻组的VAS评分、D1/D2明显低于全麻组(P<0.05),镇痛泵使用时间长于全麻组(P<0.05),产妇满意度高于全麻组(P<0.05)。结论腰麻后PCIA效果优于全麻,麻醉方式的选择可能会给患者术后镇痛带来不同影响。Objective To compare postoperative pain control by patient-controlled intravenous analgesia（PCIA） in parturient women undergoing cesarean section（CS） using general versus spinal anesthesia. Methods ＂ Sixty cases of parturient who willing to accept postoperative pain manage from June 2010 to June 2012 were enrolled and divided into general anesthesia group and spinal anes- thesia group. After CS procedure, the two groups of patients received intravenous electronic analgesia pump. Quality of the patients＂ pain was evaluated by visual analogue scale at rest, and maternal satisfaction score was also evaluated by VAS. The demographic data and analgesia pump use time, press the number of times （ D1, demand） and the actual number of entrances （ D2 delivery）, and incidence of complications were recorded in both groups. Results At postoperative 1 - 2 h ,4 h, 16 h and 24 h time points VAS scores in the spi- nal anesthesia group were significantly lower than that in the general anesthesia group（ P 〈 0.05 ）. The time of analgesia pump use in the spinal anesthesia group was longer than that in the general anesthesia group（ P 〈 0.05 ）. The D1/D2 in the spinal anesthesia group was lower than that in the general anesthesia group（ P 〈 0. 05 ）. The maternal satisfaction of the spinal anesthesia group was higher than that of the general anesthesia group （ P 〈 0. 05 ）. Condusion Spinal anesthesia is comparable to general anesthesia in terms of post-op- erative pain control. The type of anesthesia in CS may have a different effect on post-operation pain.

关 键 词：剖宫产 患者自控镇痛 全麻 腰麻 术后疼痛 

分 类 号：R614.2[医药卫生—麻醉学] R614.42[医药卫生—外科学]