三种不同方法或技术用于术后镇痛的临床效果观察

Clinical Study of Three Different Methods or Techniques of Postoperative Analgesia

目的:观察比较三种不同方法或技术用于手术后镇痛效果。方法:全组均为硬膜外麻醉后,随机分为硬膜外镇痛泵组(简称PCEA组,n=40)、静脉镇痛泵组(简称PCIA组,n=40)和硬膜外联合静脉镇痛泵组(简称E-PCIA组,n=40)。比较术后镇痛效果和副作用。结果:PCIA组在术后8h VAS评分和按键次数均明显大于或多于PCEA组(P<0.05和P<0.01)。PCEA组和E-PCIA组各阶段VAS评分和按键注药次数相似(P>0.05)。术后24h副作用比较:头痛头昏PCIA组明显高于PCEA组(P<0.05)。排尿困难和下肢无力:PCEA组明显多于PCIA组和E-PCIA组(P<0.05)。副作用发生率:PCEA组明显高于E-PCIA组(P<0.05)。结论:E-PCIA是一种更为科学合理的镇痛方法和技术,其镇痛效果确切,术后管理方便,安全可靠,患者乐意接受。

Objective： To compare the effect of the three methods or techniques of postoperative analgesia. Methods： All the objects were divided into three groups randomly after the epidural anesthesia. They were the epidural analgesia group （PCEA for short, n = 40）, the intravenous analgesia group （PCIA for short, n = 40） and the combined epidural - venous analgesia group （E - PCIA for short, n = 40）. Then the analgesia effect and the side effect would be compared. Results： The VAS score and the times of button - clicking （8 hours after operation） of the PCIA group were much larger than that of the PCEA group obviously （P 〈 0.05 and P 〈 0.01, respectively）. The VAS score and the times of button - clicking for injecting drug on each stage between the PCEA and E - PCIA group were similar （P 〉 0.05）. With respect to the side effect （24 hours after operation）： the headache symptom in the PCIA group was more serious than that in the PCEA group obviously, the retention of urine and lower extremity symptom in the PCEA group were more common than that in PCIA group and E - PCIA group（P 〈 0.05）, respectively. The frequency of side effect in PCEA group was much larger than in E - PCIA group. Conclusion： The E - PCIA is a more scientific and reasonable analgesia method or techniques. The quite analgesic effect, the easy management after operation and the safety enable E - PCIA to be trusted by the patients.