痔术后长效止痛剂镇痛与硬膜外自控镇痛效果比较

Comparison on the Efficacy of Long-acting Anodyne and PCEA after Operation for Hemorrhoids

比较长效止痛剂与硬膜外病人自控镇痛（PCEA）在痔术后镇痛的临床疗效。选择混合痔外切内扎术58例，分为长效止痛剂组（28例）和PCEA组（30例）。长效止痛剂组用1％亚甲蓝2ml加0．25％布比卡因8ml组成复方亚甲蓝注射液，于手术结束时沿切缘及基底作点状及皮内注射。PCEA组以丁卡因、舒芬太尼、氟哌利多配成混合液100ml置于PCA泵内，行自行给药经硬膜外镇痛，持续72h。于手术后12h，24h，48h，72h，96h，120h分别观察记录疼痛评分（VAS）、尿潴留及恶心呕吐等不良反应。结果显示，术后72h内PCEA组镇痛效果优于长效止痛剂组（P〈0．05），两组尿潴留、恶心呕吐发生率无显著性差异。结果表明，混合痔外切内扎术后应用PCEA镇痛效果优于长效止痛剂。

The aim of this study was to compare the clinical efficacy of long-acting anodyne and patient controlled epidural analgesia（PCEA） after operation for hemorrhoids. The 58 patients with mixed hemorrhoids to be received external resection ＆ internal ligation were selected and divided into long-acting anodyne group（ n =28） and PCEA group（ n =30）. In long acting anodyne group the compound methylene blue injection（1 % methylene blue 2ml＋0.25% bupivacaine 8ml） was intradermally and point-shaped injected along with incisal edge and basement at the end of operation;in PCEA group patients performed PCEA by using PCA pump in which tetracaine,sufentanil and droperidol were mixed to 100ml solution）,for 72h. At 12,24,48,72,96,120h after operation such adverse reactions as uroschesis, nausea and vomiting, etc, as well pain VAS were observed and recorded. As results, within postoperative 72h the efficacy of PCEA group was superior to that of long acting anodyne group（ P 〈0. 05） ;there were not significant difference in incidences of uroschesis, nausea and vomiting between both groups. These indicate that after external resection ＆ internal ligation for mixed hemorrhoids the analgesic efficacy of PCEA is superior to that of long-acting anodyne.