PCA评价体表电刺激对心外科术后疼痛疗效的对照研究

A CONTROLLED STUDY TO EVALUATE THE ANALGESIC EFFECT OF TRANSCUTANEOUS ELECTRIC NERVE STIMULATION ON POST-OPERATIVE PAIN IN PATIENTS OF CARDIAC OPERATION: PATIENT-CONTROLLED ANALGESIA AS THE EVALUATION CRITERION

心外科术后疼痛不仅给病人带来痛苦，也会影响全身各系统的功能，甚至会导致肺不张、心衰等严重的并发症。临床上通常采用麻醉性镇痛药或局麻药区域阻滞缓解术后疼痛，但这两类药物均存在一定的副作用及并发症。近年来，体表神经电刺激（transcutaneouselectricnervestimulation，TENS）开始用于心脏外科术后镇痛，但有关研究常得出相互矛盾的结果。本工作以病人自控镇痛（patientcontrolledanalgrsia，PCA）法作为评价指标，以电极安慰组作为对照，对33例心脏外科术后疼痛患者进行了TENS术后镇痛的疗效观察。结果表明，在PCA存在的条件下，TENS能够显著降低疼痛评分，减少PCA的用药次数和用药量（ANOVA，P＜0．01）。本工作为心脏外科术后常规应用：TENS镇痛提供了依据。

Post-operative pain is a common outcome after a surgical operation. Narcotic analgesic or local anesthetics are usually used in this condition. Both of them may lead to undesired side-effects. Recently, transcutaneous electric nerve stimulation (TENS) was found to be useful in post-operative analgesia after cardiac surgery. However, results of the studies remaine controversial. In the present study, we examined the analgesic effect of TENS on post-operative pain in 33 patients immediately after cardiac operation. The dosage of narcotic analgesics in patient controlled analgesia (PCA) were used as the evaluative criterion. A mock TENS group was used as control. The results show that TENS reduced the pain score with visual analogue scale at the presence of PCA. TENS also reduced the number of demands and injections of PCA (ANOVA, P<0.01) compared with control group. Our work suggests that TENS may be proved to be a useful method in treating post-operative pain after cardiac surgery.