静脉和硬膜外自控镇痛技术在外科手术后的临床镇痛效果比较

Compared clinical assessment of the effect of PCIA with PCEA

目的:比较静脉与硬膜外病人自控镇痛(PCIA、PCEA)在外科手术后的临床镇痛效果。方法:选取ASA(Ⅰ～Ⅱ)级患者90例,随机分布为PCEA组,PCIA组和对照组。PCEA和PCIA组给予相应的方法镇痛,对照组不给任何药物,观察术后6小时VAS评分,镇静效果及不良反应。结果:PCIA组尿潴留的发生明显低于PCEA组(P<0.05),PCEA的肠蠕动恢复快于PCIA(P﹤0.01),但两组病人术后镇痛效果及其他并发症并无显著差异,对照组术后6小时血清皮质醇量高于PCA镇痛组(P<0.01)。结论:PCEA和PCIA均有较好的镇痛效果,但PCIA组尿潴留发生率低,呼吸抑制发生率较高,肠蠕动恢复较PCEA慢。

Objective To compare the clinical effect and side-effect of intravenous PCA（PCIA） with epidural PCA（PCEA）.Methods Choosing ASA （Ⅰ ～ Ⅱ） level ninty postoperative patients, who were randomly divided into three groups：group PCIA,group PCEA and control .The group PCEA and PCIA were given corresponding method an analgesia , group control not given any medicine, VAS observing skill last 6 hours grades , Calm effect and side-effect. Results The incidence of urinary retention in group PCIA were signifcantly lower than that in group PCEA （P〈0.05）, The recovery of bowel movement in group PCEA were much more rapidly than that in group PCIA （P〈0.01）, but two sets of patient skill queen analgesic effect and their complication and notable difference of nothing , At 6th hour after operation,control group patients was much higher than that of PCA （P〈0.01）. Conclusion PCEA and PCIA have the pretty analgesic effect equally ,but PCIA urinary retention occurrence rate is low , breath restraint occurrence rate is higher , in testines wriggles to recover slower than PCEA.