开腹胃肠道术后局部麻醉镇痛与静脉自控镇痛的临床效果比较  

A comparison of analgesic efficacy and clinical effects between local anesthesia and intravenous patient controlled analgesia after open gastrointestinal surgery

作　　者：吕赤[1] 张忻平[1] 李瑾[1] 张成[1] 蒋会勇[1] 张雪峰[1] 

机构地区：[1]辽宁省沈阳军区总医院普通外科,110840

出　　处：《中华全科医学》2014年第4期531-533,共3页Chinese Journal of General Practice

摘　　要：目的比较开腹胃肠道术后患者局部麻醉镇痛与静脉自控镇痛(PCIA)的临床效果。方法回顾性分析2012年2月—2012年12月间沈阳军区总医院普通外科116例行开腹胃肠道手术患者资料,术后60例采用局部麻醉镇痛,另外56例应用PCIA镇痛,比较2组镇痛效果。结果 2组患者年龄、性别、身高、体重、手术类型、术后1 d与2 d视觉模拟评分(VAS)、是否追加镇痛药、恶心、呕吐、皮肤瘙痒、眩晕、术后排气时间差异均无统计学意义(均P>0.05),但PCIA组出现嗜睡者(6例,10.7%)多于局部麻醉镇痛组(0例,0.0%),而局部麻醉镇痛组出现局部渗液者(7例,11.7%)多于PCIA组(0例,0.0%),上述差异有统计学意义(均P<0.05)。结论术后局部麻醉镇痛同静脉自控镇痛均具有良好的临床效果,可作为术后疼痛管理选择之一。Objective To compare the analgesic efficacy and clinical effects between the local anesthesia and intravenous patient controlled analgesia （ IV PCA ） in patients undergoing open gastrointestinal surgery. Methods A retrospective case-control study was conducted. 116 patients after the open gastrointestinal surgery from February to December in 2012 were divided into the trial group（60 cases with local anesthesia） and the control group （56 cases with IV PCA）. Visual analogue scale （VAS） was assessed on 1 st and 2nd day after the operation. Results There were no significant differences in age, gender, height, body weight, operation types, postoperative VAS scores （ on first and second clay） , using of addition- al analgesics, nausea, vomiting, pruritus of skin, dizziness and exhausting time between the two groups （ P 〉 0.05 for all comparisons）. But the number of cases with drowsiness in the control group （6 cases, 10.7% ） was higher than that in the trial group（0 ease,0.0% ） ,and the number of cases with leakage of liquid in trial group（7 cases, 11.7% ） was higher than that in the control group（O case,0.0% ）, and the difference was statistically significant（ P 〈 0.05 ）. Conclusion Local anesthesia has the same analgesic efficacy and clinical effects as IV PCA, and can be consider as one of the options in postoperative pain management.

关 键 词：局部麻醉镇痛 静脉自控镇痛 术后镇痛 

分 类 号：R614.2[医药卫生—麻醉学] R656.6[医药卫生—外科学]