术后病人硬膜外自控镇痛与单次注药镇痛的对比观察  

Study on the effective comparision of PCEA to EPI injection in post-operative patients

作　　者：杨泉芝[1] 孔航[1] 

机构地区：[1]贵州省贵阳市第一人民医院麻醉科,贵州贵阳550002

出　　处：《右江民族医学院学报》2000年第6期873-875,共3页Journal of Youjiang Medical University for Nationalities

摘　　要：将 6 0例硬膜外麻醉下行胆道手术的病人随机分成两组 ,硬膜外自控镇痛 (PCEA)组 (n =30 ) ,硬膜外单次注药(EPI)组 (n =30 )。手术结束时 ,PCEA组硬膜外导管接自控镇痛泵 (简称PCA) ,药液用 0 .0 0 6 %吗啡加 0 .15 %布比卡因 ,由病人自行给药镇痛。EPI组经硬膜外导管一次注入吗啡 2mg。在术后 4、8、12、2 4h进行随访并记录 :①疼痛评分 (用VAS法 ) ;②平均动脉压 (MAP)和呼吸频率 (RR) ;③副作用发生率如呼吸抑制、恶心、呕吐、尿潴留等。结果显示 :在术后各时点的VAS评分两组差异无显著性 (P >0 .0 5 ) ,MAP及术后 4hRR两组差异也无显著性 (P >0 .0 5 ) ,而术后 8、12、2 4h两组RR变化都在正常范围但差异有显著性 ( P <0 .0 1或P <0 .0 5 ) ,2 4h副作用发生率两组差异亦无显著性 ( P >0 .0 5 )。认为PCEA和EPI两种方法都有良好的镇痛效果和安全性 ,但PCEA更能满足机体的个体差异 。Sixty patients who had undergone biliary tract surgery with epidural analgesia had been randomized into two groups: Group Ⅰ ( with PCEA-Patient Controlled Epidural Anesthesia, n=30) and Group Ⅱ ( with EPI-epidural injection, n=30). When the operation was over, patients in Group Ⅰ were connected to a PCA by epidural catheter and controlled analgesia themselves, with 0.006% Morphine fluid plus 0.15% bupivacaine (n=30). Patients in Group Ⅱ were given Morphine 2mg by epidural catheter each time. Follow-up at 4, 8,12 and 24 hours evaluated ①analgesia evaluation (VAS methods); ②Mean Arterial Pressure (MAP) and Respiration Rate (RR); ③incidence of side effects such as respiratory inhibition, nausea, and vomiting, etc. Results showed that there was no statistical difference in VAS evaluationat each time between these groups (P>0.05), and there were also no statistical difference in MAP and RR 4 hours after operation (P>0.05). While the changes of RR were within normal range, but the differences were statistically significant (P<0.01 or P<0.05), but the incidence of side effect within 24 hours between the two groups is of no statistical significance (P>0.05). It can be concluded that both PCEA and EPI injection have good analgesia and safety, but PCEA can meet the needs of differing individuals and provide more satisfaction.

关 键 词：镇痛 硬膜外自控镇痛 单次注药 术后镇痛 

分 类 号：R614.42[医药卫生—麻醉学]