持续硬膜外间隙脉冲输注与静脉持续输注用于术后自控镇痛的安全性和有效性比较  

The safety and effectiveness of continuous epidural space pulse injection in postoperative self-controlled analgesia

作　　者：耿春香 雷秀旺 朱延华 陈春生 高亚川 GENG Chunxiang;LEI Xiuwang;ZHU Yanhua(Department of Anesthesiology,The Sixth People’s Hospital of Hengshui City,Hebei,Hengshui 053200,China)

机构地区：[1]河北省衡水市第六人民医院麻醉科,053200 [2]河北省衡水市第六人民医院妇产科,053200 [3]河北省衡水市第六人民医院骨科,053200

出　　处：《河北医药》2021年第20期3133-3135,3139,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20191092)。

摘　　要：目的研究持续硬膜外间隙脉冲注入技术(PIEB)在术后镇痛中的临床效果。方法选取2017年12月至2018年10月收治的进行外科手术的临床患者100例,采用随机抽签的方式分为试验组和对照组,每组50例。试验组实施持续硬膜外间隙脉冲输注技术(PIEB)自控镇痛,对照组实施静脉持续输注输注自控镇痛。观察3 h、6 h、12 h、24 h、36 h、48 h的心率与血氧饱和度情况、镇痛效果、镇静评分、PCA次数、镇痛总时长、各种并发症、辅助用药等指标进行观察记录。结果观察2组患者的镇痛后评分,试验组的疼痛评分小于对照组,差异无统计学意义(P>0.05);观察患者术后3 h、6 h、12 h、24 h、36 h、48 h的生命体征,试验组的心率和血氧饱和度,观察2组不良反应情况,试验组发生恶心、呕吐2例、下肢麻木3例、瘙痒1例,头晕头痛1例,不良反应的发生率14%对照组发生恶心、呕吐3例、反应迟缓1例、头晕头痛3例,不良反应的发生率为16%,试验组的不良反应发生率均低于对照组,差异具有统计学意义(P<0.05)。结论硬膜外术后镇痛具有镇痛效果确切、个体差异小、应用面广、性价比高的优点,而硬膜外间歇脉冲输注技术可以快速将药物注入硬膜外腔,同等剂量的药物可以获得更好的镇痛平面,减少患者自控给药次数,延长镇痛时长,极大缓解了患者的疼痛,提高患者的舒适度,提高患者就医满意度,与静脉持续输注技术相比在并发症方面没有明显差异。值得在临床上推广应用。Objective To investigate the therapeutic effects of continuous epidural space pulse injection(PIEB)in postoperative self-controlled analgesia.Methods A total of 100 patients who underwent surgery in our hospital from 2017 to 2018 were randomly divided into experimental group(n=50)and control group(n=50).The patients in experimental group were treated by PIEB,while those in control group were treated by continuous intravenous infusion.The heart rate,blood oxygen saturation,analgesic effect,sedation score,PCA times,total duration of analgesia,various complications,auxiliary medication and other indicators at 3h,6h,12h,24h,36h and 48h were observed and compared between the two groups.recorded.Results The pain scores in observation group were lower than those in control group,but the differences were not significant(P>0.05).The incidence of adverse effect in observation group was 14%,with 2 cases of nausea and vomiting,3 cases of numbness of lower limbs,1 case of itching and 1 case of dizziness and headache.And the incidence of adverse effect in control group was 16%,with 3 cases of nausea and vomiting,1 case of delayed reaction and 3 case of dizziness and headache.The incidence of adverse reactions in experimental group was significantly lower than that in control group(P<0.05).Conclusion Epidural analgesia has the advantages of exact analgesic effect,smaller individual difference,wider application and higher performance-price ratio.PIEB can quickly inject drugs into epidural space,reduce the number of patients’self-controlled medication,prolong the duration of analgesia,greatly relieve patients’pain and improve patients’comfort,with equal dose and better effects,which is worthy of clinical promotion and application.

关 键 词：硬膜外间隙脉冲输注 静脉持续输注 术后镇痛 

分 类 号：R619[医药卫生—外科学]