自控鞘内镇痛在盆腔术后镇痛的应用

THE APPLICATION OF PATIENT CONTROL SPINAL ANALGESIA AFTER GYNAECOLOGY PELVIC OPERATION

目的:研究病人自控蛛网膜下腔镇痛于妇科盆腔手术术后镇痛的应用。方法:择期行子宫切除术病人80例,随机分为病人自控蛛网膜下腔镇痛组(PCSA,n=40),病人自控硬膜外镇痛组(PCEA,n=40),均以吗啡为镇痛药物采用相应浓度进行患者自控镇痛。观察记录患者术后不同时点镇痛情况及术后50 h总体镇痛评价。记录两组所用吗啡剂量、按压次数及不良反应情况。结果:两组镇痛效果满意,除术后6 h外无明显差异;两组间不良反应无明显差别;PCEA组吗啡使用剂量及按压次数较PCSA组多。结论:连续蛛网膜下腔镇痛可达到较硬膜外镇痛更满意的镇痛效果,用药量少,不良反应发生率降低,是一种安全、有效的镇痛方法。

Objective： To study the feasibility of the patient control spinal analgesia after gynaecology pelvic operation. Methods： Eighty patients scheduled for hysterectomy were randomly divided into two groups： group PCSA was patient control spinal analgesia, group PCEA was patient control epidural analgesia. Both groups were used morphine of relevant concentration for patient control analgesia. Observing the analgesic effect at 1, 6, 12, 24, 48h after the operation and recording visual analogue scale （VAS） of each point, recording the value of total analgesic effect at 50h after the operation. Recording the morphine dosage, press times and side effects of two groups.Results： The analgesic effect was satisfied, and it was no significantly difference between the two groups （P〉 0.05） except for 6h. The side effects of two groups were no significantly difference. The morphine dosage, press times of group PCEA were more than that of group PCSA. Conclusion： The patient control spinal analgesia for gynaecology pelvic operation is feasible.