骨科病人术后应用PCA镇痛与麻醉药镇痛效果的比较研究

Effect of analgesia of the orthopedic patients between PCA and intramuscular nanotic drugs

目的观察术后应用自控镇痛（PCA）和肌注麻醉药物镇痛两种镇痛方法是否达到满意的镇痛效果。方法将同期骨科住院手术的病人60例进行随机分为两组。A组观察组采用Go Medical一次性PCA泵装置；B组对照组术后肌肉注射杜冷丁50-75 mg，或杜冷丁50mg＋非那根25 mg。选取恶心、呕吐、镇静、VAPS疼痛评分4个项目分别对两组术后病人进行评分。结果观察组PCA镇痛效果优于对照组，在恶心、呕吐、镇静3个项目上无显著差异。结论PCA方式镇痛是一种有效的临床术后镇痛方法。通过静脉、皮下或硬膜外给药，在方便快捷、反应迅速的同时，将对镇痛药用量的个体差异性降到了最小，与传统肌注镇痛比较，能维持有效血药浓度，减少副作用。

Objective ： To observe the effect of analgesia of the postoperative patients using the two methods of PCA and intramuscular nanotic drugs. Methods： The 60 postoperative patients in the Orthopedic Department in the same period were randomly divided into two groups. The disposable PCA pump instrument was used in the observation group and instramuscular dolautin 50 - 70 mg was used in the controll group. The four items of nausea, vomiting sedation and VAPS pain was selected for scoring the patients. Results ： The analgesic effect of the observation group was better than that of the controll group. There were no significant differences in the nausea, vomiting and sedation. Conclusion： PCA is a useful postoperative analgesic method. By intravenous, subcutaneous and epidural administration, it can minimize the individual differences in the analgesic drug dose. At the same time it is convenient and rapid in response. Compared with the traditional method, it can keep the effective drug concentration in blood and reduce the side effects.