多模式镇痛在腹腔镜辅助下结直肠癌根治术术后镇痛的临床观察  

The Clinical Observation of Multimodal Analgesia Used for Postoperative Analgesia of Laparoscopic Assisted Colorectal Carcinoma

作　　者：黎振平[1] 陈裕强[2] 黄卓梅 高晓枫[1] 汪飞[1] 杨骥云[1] 

机构地区：[1]广东省惠州市第一人民医院,广东惠州516001 [2]广东省惠州市中心人民医院

出　　处：《中国医学创新》2017年第10期9-12,共4页Medical Innovation of China

基　　金：2015年广东省惠州市科技计划项目(医疗卫生)(2015Y061)

摘　　要：目的:探讨多模式镇痛在腹腔镜辅助下结直肠癌根治术术后镇痛的效果。方法:选择60例腹腔镜辅助下结直肠癌根治术手术患者,随机将其分为多模式镇痛组(A组)和患者自控镇痛组(B组),每组各30例。比较两组患者术后48 h内各时间点VAS﹑BCS和Ramsay评分﹑PCA按压次数以及不良反应。结果:A组VAS镇痛评分明显低于B组(P<0.05),BCS舒适状态评分A组高于B组(P<0.05),PCA实际按压次数A组低于B组(P<0.05)。结论:多模式镇痛明显优于单纯患者自控镇痛,可减少患者阿片类药物的使用,避免了阿片类药物剂量过大,从而降低不良反应的发生率和严重程度,增强术后镇痛效果,有利于术后快速康复。Objective： To investigate the analgesic effects of muhimodal analgesia using in laparoscopic assisted radical operation of colorectal cancer.Method： A total of 60 patients who underwent laparossopic assisted radical operation of colorectal cancer were selected, they were randomly divided into the group A and B, 30 cases in each group.The group A was given multimodal analgesic, the group B was given patient-controlled analgesic regimen.The visual analog scale （ VAS ）, bruggrmann comfort scale （ BCS ）, Ramsay scores, number of times on pressing the PCA pump and side effects of two groups were compared.Result： The VAS scores in group A were significantly lower than those in group B （ P〈0.05 ） .The BCS scores in group A were higher than those in group B （ P〈0.05 ） .The actual number of times on pressing the PCA pump in group A were lower than those in group B （ P〈0.05 ） .Conclusion： The multimodal analgesic regimen in this study appears to be more effective than conventional patient-controlled analgesic regimen, which can not only avoid the high close requirements of opioids,but also reduse the incidence rate and severity of adverse reactions caused by opioids. Furthermore, muttimodal analgesia can efficiently relief postoperative pain and accelerate patients＇ recovery.

关 键 词：多模式镇痛 结直肠癌根治术 舒芬太尼 帕瑞昔布钠 氟比洛芬酯 

分 类 号：R614[医药卫生—麻醉学] R735.34[医药卫生—外科学]