长期饮酒对肿瘤患者术后镇痛效果的影响:大样本、回顾性分析  

Effect of chronic alcohol intake on postoperative analgesia in cancer patients:a large sample,retrospective analysis

作　　者：张建锋[1] 邢春花[2] 王迪 陈小红[1] 郁燕[1] 尹倩 刁怀悦 陈烨 曹汉忠[1] Zhang Jianfeng;Xing Chunhua;Wang Di;Chen Xiaohong;Yu Yan;Yin Qian;Diao Huaiyue;Chen Ye;Cao Hanzhong(Department of Anesthesiology,Affiliated Cancer Hospital of Nantong University,Nantong 226361,China;Department of Anesthesiology,Nantong Third People's Hospital,Nantong 226361,China)

机构地区：[1]南通大学附属肿瘤医院麻醉科,226361 [2]南通市第三人民医院麻醉科,226361

出　　处：《中华麻醉学杂志》2019年第11期1291-1293,共3页Chinese Journal of Anesthesiology

基　　金：南通市科技项目基金(MS32015013)。

摘　　要：目的评价长期饮酒对肿瘤患者术后镇痛效果的影响。方法选择无线镇痛管理系统数据库内2016年1月1日至2018年10月22日行术后智能化PCA管理的男性肿瘤患者,年龄≥18岁,ASA分级Ⅰ或Ⅱ级。按照饮酒情况分为对照组和长期饮酒组。麻醉方法为静吸复合麻醉。术后采用舒芬太尼PCIA或PCSA。中度疼痛时(4分≤静态或动态NRS评分≤6分)调节镇痛泵参数补救镇痛,重度疼痛时(静态或动态NRS评分≥7分)静脉注射地佐辛5 mg补救镇痛。记录术后镇痛泵有效按压次数、实际按压次数、舒芬太尼用量和中重度疼痛发生情况;记录术后恶心、呕吐、瘙痒、眩晕和低血压等不良反应的发生情况。结果本研究纳入1914例患者,对照组1508例,长期饮酒组406例。与对照组比较,长期饮酒组镇痛泵有效按压次数、实际按压次数、术后舒芬太尼用量和中重度疼痛发生率升高(P<0.05),术后恶心呕吐、瘙痒、眩晕和低血压发生率差异无统计学意义(P>0.05)。结论长期饮酒可降低肿瘤患者术后镇痛效果。Objective To evaluate the effect of chronic alcohol intake on postoperative analgesia in cancer patients.Methods American Society of Anesthesiologists physical statusⅠorⅡmale patients,aged≥18 yr,underwent postoperative intelligentized patient-controlled analgesia management from January 1,2016 to October 22,2018,searched from wireless analgesia management system database,were selected.The patients were divided into control group and chronic alcoholic intake group according to the history of chronic alcoholic intake.Combined intravenous-inhalational anesthesia was used during surgery.Patient-controlled intravenous or subcutaneous analgesia was performed with sufentanil.When moderate pain occurred(4 points≤numeric rating scale score≤6 points),the parameters of analgesia pump was regulated for rescue analgesia.When severe pain occurred(numeric rating scale score at rest or during activity≥7 points),dezocine 0.5 mg was intravenously injected as rescue analgesic.The effective pressing times,the number of attempts,consumption of sufentanil and occurrence of moderate or severe pain were recorded.The adverse reactions such as nausea and vomiting,pruritus,dizziness and hypotension were also recorded.Results A total of 1914 patients were enrolled in this study,with 1508 cases in control group and 406 cases in chronic alcoholic intake group.Compared with control group,the effective pressing times,the number of attempts,consumption of sufentanil and incidence of moderate or severe pain were increased(P<0.05),and no significant change was found in the incidence of nausea and vomiting,pruritus,dizziness or hypotension in chronic alcoholic intake group(P<0.05).Conclusion Chronic alcohol intake can decrease the efficacy of postoperative analgesia in cancer patients.

关 键 词：饮酒 疼痛 手术后 镇痛 病人控制 

分 类 号：R614[医药卫生—麻醉学]