老年胃切除术病人静脉与硬膜外自控镇痛效果的对比观察  

Comparison of Intravenous and Epidural Patient-control Analgesia in the Elderly after Gastrectomy

作　　者：黄宁[1] 杨光[1] 林鹰[1] 

机构地区：[1]哈尔滨医科大学第三临床医学院麻醉科,黑龙江哈尔滨150040

出　　处：《黑龙江医学》2002年第9期659-660,共2页Heilongjiang Medical Journal

摘　　要：目的　比较老年人施行胃切除术用静脉与硬膜外自控镇痛的效果。方法　选取ASAⅠ～Ⅱ级 ,年龄 >70岁 ,拟施胃切除手术的病人 30例 ,随机分成 2组 :A组 (n =15 ) ,常规全麻后 ,采用静脉内注射吗啡PCA进行术后镇痛 ;B组 (n =15 ) ,常规全麻后 ,采用硬膜外内注射布比卡因和芬太尼PCEA进行术后镇痛。分别观察术后 5d内 ,病人VAS评分 ,精神状态 ,胃肠道功能 ,心肺功能的情况。结果　B组术后前 2dVAS评分均低于A组 (P <0 0 5 ) ,病人精神状态良好 ,胃肠道及心肺功能未受明显影响。结论　老年人胃切除术后PCEA镇痛效果优于PCA镇痛。Objective To compare the effect of intravenous and epidural patient-control analgesia in the elderly after gastrectomy. Methods 30 gastrectomy patients ASA I-II who were older than 70 were randomly divided into 2 groups. In group A (n=15): general anesthesia followed by postoperative patient-controlled analgesia (PCA) with intravenous morphine; In group B (n=15): general anesthesia followed by postoperative patient -controlled epidural analgesia (PCEA) with a mixture of bupivacaine and fentanyl. Visual analog scale, mental status, gastrointestinal function and cardiorespiratory function were measured in 5 days after operation. Results In group B visual analog scale was low significantly in the initial 2 days postoperation compared with group A (P<0.05). The patients' mental status, gastrointestinal function and cardiorespiratory function were very well. Conclusion After gastrectomy in the elderly patient, patient-controlled epidural analgesia (PECA) might be better than PCA.

关 键 词：胃切除术 硬膜外自控镇痛 静脉麻醉 效果比较 老年人 

分 类 号：R614[医药卫生—麻醉学] R656.61[医药卫生—外科学]