两种镇痛方案对腹腔镜辅助结肠癌根治术后镇痛的临床观察  

Clinical study of two analgesic regimens for postoperative analgesia after colon cancer surgery assisted with laparoscopy

作　　者：王卉 吴学东[1] 张侠 WANG Hui(Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou ,Jiangsu,215002,China)

机构地区：[1]南京医科大学附属苏州医院,江苏苏州215002

出　　处：《齐齐哈尔医学院学报》2018年第16期1869-1871,共3页Journal of Qiqihar Medical University

摘　　要：目的比较两种术后镇痛方案对腹腔镜辅助结肠癌根治术后镇痛效果。方法选择2017年6月—2018年1月期间入住本院行择期腹腔镜辅助结肠癌根治术患者60例(男41例,女19例,年龄47~81岁),采用随机数字表随机分为研究组和对照组,每组各30例。研究组患者术前鞘内注射200 ug吗啡,术毕氟比洛芬PCIA,对照组患者术毕舒芬太尼+氟比洛芬PCIA,分别观察两组术后6 h、12 h、24 h静息和活动状态下NRS疼痛评分、PCA次数、肠通气时间、不良反应情况以及患者总体满意度。结果研究组在6 h和12 h两个时点静息和活动状态下NRS评分低于对照组,P<0.05,实验组患者PCA需求明显降低,肠功能恢复较快,满意度较高,P<0.05。研究组患者瘙痒发生率高于对照组,恶心呕吐发生率两组无统计学差异(P>0.05)。结论鞘内小剂量吗啡联合氟比洛芬PCIA镇痛可为腹腔镜辅助结肠切除患者提供优良的术后镇痛,利于患者术后早期活动及肠功能恢复。Objective To compare the efficacy of two analgesic regimens in patients after colon cancer surgery assisted with laparoscopy.Methods Sixty patients (41 males,19 females,47-81 years old)undergoing elective colon cancer surgery assisted with laparoscopy were randomly divided into experiment group and control group using a random table,30 cases in each group.Participants in experiment group received 200 μg morphine intrathecally before surgery and patient-controlled intravenous analgesia with flurbiprofen after surgery.Patients in control group received patient-controlled intravenous analgesia with a combination of flurbiprofen and sufentanil after surgery.Pain scores at rest and on movement at 6^th,12^th,and 24^th hours after surgery,PCA requirement, the incidence of side effects,recovery and patient's satisfaction were recorded.Results Both NRS-R and NRSM in experiment group were significantly lower than control group at 6^th,12^th hours after surgery (P<0.05),while there was no difference between two groups at 24 hours.Patients in experiment group had significantly lower PCA requirement,faster return of bowel function and higher satisfaction (P<0.05).The incidence rate of pruritis was 26.7% in experiment group,which was significant higher than control group (P<0.05),There were no significant differences in the incidence of nausea and vomiting between the two groups.Conclusions Intratheeal morphine combined with flurbiprofen PCIA can provide excellent postoperative analgesia for patients with laparoseopic assisted colectomy,which is beneficial to early postoperative activities and recovery of bowel function.

关 键 词：术后镇痛 吗啡 氟比洛芬 腹腔镜 

分 类 号：R614[医药卫生—麻醉学]