术后两种镇痛方式对胃肠功能的影响  

A Randomized Non-double-blind Comparison of Effect of Patient Controlled Epidural Analgesia with Intermitted Muscle Pethidine Injection on Gastrointestinal Motility

作　　者：李正[1] 朱彪[2] 蒋豪[2] 

机构地区：[1]上海市松江区中心医院麻醉科,上海201600 [2]复旦大学附属中山医院麻醉科,上海200032

出　　处：《中国临床医学》2003年第4期501-502,510,共3页Chinese Journal of Clinical Medicine

摘　　要：目的 :通过对病人自控硬膜外镇痛 (PCEA)和间断肌肉注射哌替啶进行不同术后镇痛病人胃肠功能指标恢复的观察 ,判断这两种不同术后镇痛方式对胃肠功能恢复的影响。方法 :4 0例单纯胆囊切除术后病人 ,随机分成处理组和对照组 ,处理组术后病人行PCEA镇痛 ,对照组病人手术当晚肌肉注射哌替啶 10 0mg ,观察术后 3d肠鸣音恢复情况 ,第 1次恢复肛门排气、排便时间 ,记录术后至恢复出院时间 ,及饮食恢复情况 ,记录术后镇痛效果。结果 :组间比较第 1次肛门排气、排便恢复时间 ,术后至恢复出院时间无显著差异 (P >0 .0 5 ) ,术后当晚肠鸣音恢复处理组较对照组有显著差异 (P <0 .0 5 ) ,组间饮食恢复构成有显著差异 (P <0 .0 5 )。处理组肠鸣音第 1、第 3天恢复 ,对照组术后第 2天恢复肠鸣音 (P >0 .0 5 )。结论 :处理组在镇痛效果明显优于对照组情况下 ,PCEA术后镇痛可以促进肠鸣音的早期恢复 ,对胃肠道功能的最终恢复无明显影响。Objective: A clinical observation was conducted to determine whether PCEA would speed recovery of postoperative gastrointestinal motility or not in patients undergoing cholecystectomy. Methods: 40 patients undergoing plain cholecystectomy were divided into two groups. 19 patient were given intermitted muscle-administered pethidine. 21 patients were treated with PCEA for postoperative pain relief for 1-3 days, with mixture solution 0.125%-0.15% bupivacaine and 2-4 micromg/ml fentanyl. The first discharge of fecus, the bowel movement of three days after operation, the first discharge of flatus, time of discharge from hospital, recovery condition of diet and efficacy of pain relief were recorded. Results: The first discharge of fecus, the first discharge of flatus, time of discharge from hospital have no significance between groups ( P >0.05). The early recovery of bowel movement, diet and effect of pain relief have significant difference between groups ( P <0.05). Conclusion: Under the different postoperative pain relief, PCEA has positive effect on the recovery of early bowel movement and has no difference on the final recovery of gastrointestinal motility.

关 键 词：胃肠功能 病人自控硬膜外镇痛 哌替啶 肌肉注射 术后镇痛 胆囊切除术 

分 类 号：R614[医药卫生—麻醉学]