可塞风与芬太尼联合应用于胸科手术术后病人自控静脉镇痛的疗效观察

Observation of the Curative Efficiency of the Application of Xafon and Fentanyl in the Postoperative Patient Controlled Intravenous Analgesia of Thoracic Surgery

目的:观察可塞风与芬太尼联合应用于胸科手术术后病人自控静脉镇痛的效果和副作用,并探讨这种镇痛方法的可行性。方法:胸科手术病人200例,随机分成:PCIA组(100例),术后应用自控静脉镇痛,泵内置可塞风和芬太尼;PCEA组(100例),术后应用自控硬膜外镇痛,泵内置吗啡和布比卡因。用VAS评分标准随访两组病人术后1h、4h、12h、24h、48h时的镇痛效果,记录副作用的发生率和镇痛期间的生命体征。结果:两组病人镇痛的效果相同(P>0.05),而PCEA组比PCIA组的恶心呕吐、头晕、皮肤瘙痒的发生率较高(P<0.05),两组嗜睡发生率相似(P>0.05)。结论:可塞风与芬太尼联合应用于胸科手术术后的自控静脉镇痛的效果好,副作用少,值得在临床上广泛推广。

Objective To evaluate the curative efficiency and the side effect of the application of xafon and fentanyl in the postoperative patient controlled intravenous analgesia(PCIA) of thoracic surgery,and discuss the feasibility of this use.Methods 200 cases of patients undergoing thoracic surgery are random to be divided into two groups:group of PCIA (100 cases),the patients receive patient controlled intravenous analgesia,xafon and fentany are put in the anlgesia pump;group of PCIA(100 cases),the patients receive patient controlled epidural analgesia(PCEA),mophine and bupivacaine are put into the anlgesia pump.1 h,2 h,12 h,24 h,48 h after the operation ,using the VAS method to score the effect of analgesia of the two group patients,record the incidence of the side effect and record the objective sign of life.Results The effects of two analgesia methods in diffence groups are similar(P>0.05),but the incidences of nausea,vomiting,dizziness and skin itchy of group PCEA are higher than those of guoup PCIA(P<0.05);the incidences of lethargy in the two groups are similar too(P>0.05).Conclusion The effect of analgesia method of group PCIA is better than that in Group PCEA,and get less side effect,so this analgesia method is worthy to be used in clinic.