PCEA技术在前列腺摘除术后的应用

Application of Patient-controlled Epidural Analgesia Technique after Prostatectomy

目的:探讨硬膜外病人自控镇痛(PCEA)技术在前列腺摘除术后的镇痛效果及并发症。方法:选取耻骨上经膀胱前列腺摘除术患者80例,实验组采用低浓度罗哌卡因+小剂量吗啡行硬膜外病人自控镇痛,对照组采用肌注杜冷丁药物镇痛。观察两组各时段的镇痛效果及术后48h内发生膀胱痉挛次数、持续时间及膀胱冲洗量、冲洗时间等。结果:两组各时间段的镇痛评分呈显著性差异(P<0.01);48h内膀胱痉挛次数、持续时间、膀胱冲洗量、冲洗时间等有显著性差异(P<0.01);实验组所有患者均无明显伤口疼痛等症状,镇痛良好,心血管系统、呼吸系统与术前相比均无明显变化。结论:前列腺摘除术后利用低浓度罗哌卡因+小剂量吗啡行硬膜外病人自控镇痛效果确切,可以减轻或消除病人因手术创伤引起的疼痛和减少并发症,有利于病人生理功能的稳定和康复。

Objective To discuss the analgesic effect and the complication of patient-controlled epidural analgesia （PCEA） technology after prostatectomy Methods Eighty patients underwent suprapubic prostatectomy through the urinary bladder were randomly divided into the experimental group and the comparison group, with 40 cases each： using low density ropivacaine plus a little morphine for the experimental group to carry out PCEA; and intramuscular meperidine analgesics for the comparison group, the analgesic effect of the two groups was observed itt various intervals and also the times of cystospasm, the duration and flushing quantity, the flush time of the urinary bladder within 48 hours after surgery. Results The grades of analgesia intervals of each group assumed significant differences （ P 〈 0.01 ） ; the times of cystospasm, the duration and flushing quantity, the flush time of the urinary bladder within 48 hours showed significant differences （ P 〈 0.01 ）. All the patients in each group did not have symptoms such as obvious wound ache indicating the analgesia was good enough, the cardiovascular system and the respiratory system had no obvious changes as compared with those before surgery. Condusion The effect of using low density repivacaine plus a Little morphine for the experimental group to carry out PCEA is satisfactory, it is also advantageous for the stabilization of the patient＇ s physiologic function and health.