自控静脉镇痛在口腔颌面肿瘤游离腓骨瓣修复术中的应用  

The Application of Patient Controlled Intravenous Analgesia in Patients undergoingFree Fibula Flap Reconstruction of The Oral Cancer

作　　者：苗利萍[1] 马伟英[1] 吴毅[1] 张蓉[1] MIAO Li-ping;MA Wei-ying;WU Yi;ZHANG Rong(Department of Anesthesia,Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University,Guangzhou,510120)

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,510120

出　　处：《岭南急诊医学杂志》2022年第4期344-346,350,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨自控静脉镇痛(patient controlled intravenous analgesia,PCIA)在口腔颌面肿瘤游离腓骨瓣修复术(free fibula flap,FFF)中应用的安全性和有效性。方法:回顾分析我院行FFF手术患者86例,根据术后是否行PCIA分为对照组和PCIA组,每组43例,比较两组患者术后生命体征、疼痛视觉模拟评分(visual analogue scale,VAS)、Ramsay镇静评分以及恶心呕吐、术后皮瓣相关并发症的差异。结果:PCIA组术后第一天及第二天的平均动脉压、心率和呼吸频率均低于对照组(P<0.05);PCIA组术后第一天、第二天VAS评分,术后第一天Ramsay镇静评分,恶心呕吐发生率均低于对照组(P<0.05)。结论:PCIA在口腔颌面肿瘤FFF中的应用具有安全性和有效性。Objective:To evaluate the safety and effectiveness of patient controlled intravenous analgesia(PCIA)in patients undergoingfree fibula flap reconstruction of the oral cancer.Methods:A retrospective analysis was performed on 86 patients who underwent radical treatment of oral cancer with free fibular flap reconstruction. They were divided into control group and PCIA group. The changes of postoperative vital signs,visual analogue scale(VAS)and Ramsay sedation score were compared at different time points. Differences were observed in postoperative nausea,vomiting and postoperative flap-relatedcomplications between the two groups.Results:Compared with the controlgroup,MAP and HR are lower in the PCIA group at 24 h and 48 h after surgery(P<0.05). The VAS scores of the PCIA group at 24 h and 48 h after surgery were lower than the control group(P<0.05). TheRamsaysedation scores of the PCIA group were lowerat 24 h after surgery(P<0.05). The incidence ofnausea and vomiting in the PCIA group was lower than that in the control group(P<0.05).Conclusion:PCIA can effectively relieve postoperative painin patients undergoing free fibula flap reconstruction without increased complications.

关 键 词：自控静脉镇痛 游离腓骨瓣 口腔癌 

分 类 号：R614[医药卫生—麻醉学] R739.8[医药卫生—外科学]