持续性术后镇痛中的故障排除与不良反应处理

Troubleshooting and treatment of side effects in post-operative continuous constant-dose analgesia

目的:探讨临床应用中影响一次性恒速球泵镇痛效果的机械故障或其他故障以及病人出现的不良反应。方法:对临床持续性术后镇痛3200例分为CCEA组和CCIA组进行分析。结果:CCEA组中主要以硬膜外导管因素和镇痛泵流速偏差而导致病人出现不良反应和镇痛效果不理想。而CCIA组中主要以镇痛泵流速偏差和镇痛药物导致病人出现不良反应和镇痛效果不理想。结论:加强硬膜外导管固定及管理,密切术后随访,适时的心理治疗是减少术后镇痛中机械故障和病人不良反应发生率的重要手段。

Objective ：To investigate the mechanical and other disorders of disposable continuous constant-dose analgesia pump, and the side effects in clinical application. Methods： 3200 patients receiving post-operative continuous constant-dose analgesia were distributed into 2 groups, continuous constant-dose epidural analgesia （CCEA） group and continuous constant-dose intravenous analgesia （CCIA） group. Results：The main reasons of unsatisfactory analgesia effect and side effect in CCEA group were epidural catheter disorders. The main reasons in CCIA group were infusion speed deviation of analgesia pump and analgesics. Conclusion：The important means to reduce mechanical disorders and side-effects in post-operative continuous analgesia include enhanced fixation and management of epidural catheter,intensified post-operative fellow up and psychotherapy at proper time.