前列腺摘除术后自控硬膜外镇痛30例疗效观察

Therapeutic observation of patient-controlled epidural analgesia in patients after prostatectomy (a report of 30 cases)

目的 :探讨前列腺摘除术后患者自控硬膜外镇痛 ( PCEA)的临床效果。方法 :选取耻骨上经膀胱前列腺摘除术患者 60例 ,随机分成 PCEA组和对照组 ,各 30例。 PCEA组术后通过保留的硬膜外导管连接镇痛泵持续镇痛 ;对照组给予常规术后镇痛 ,如肌注度冷丁、吗啡及镇静剂等 ,连续治疗 3d。以疼痛视觉模拟评分法 ( VSA)间接评估镇痛效果 ,记录膀胱痉挛次数、持续时间 ,对比膀胱冲洗时间、用液量及术后并发症。结果 :PCEA能明显减少膀胱痉挛性疼痛发生率、持续时间短 ;缩短膀胱冲洗时间 ;减少膀胱出血量 ;抑制收缩压上升 ( P<0 .0 5 )。结论 :PCEA对前列腺摘除术后患者镇痛效果好 ,其疗效确切、安全 ,有利于术后恢复。

Objective: To evaluate the clinical effects of patient-controlled epidural analgesia (PCEA) after prostatectomy. Methods:60 cases of patients undergoing suprapublic prostatectomy were divided into PCEA group(n=30) and control group(n=30) randomly. After operation, PCEA was applied in PCEA group, control group accepted injection of dolantin 50mg to relief pain. Analgesia effect was indirect scored on the visual analog scale(VSA). Number of times and period of bladder spasm were recored.The duration of bladder rinse and the quantity of liquid used as well as the complications of operation were compared. Results: As compared with control group, the rate and duration of bladder spasm were reduced in PCEA group(P<0.01); the lasting hours of bladder rinse was shorted(P<0.05); the quantity of bleeding was reducened(P<0.05); the elevation of systolic pressure was inhibited (P<0.05). Conclusion: The analgesia effects of PECA following prostatectomy satisfactory.Its efficacy is certain,and has merits of safe and rapid rehabilitation.