硬膜外自控镇痛不同配方临床观察

The Clinical Observation on Different Formulations in PCEA

目的:采用硬膜外自控镇痛(PCEA)技术,对胆囊切除患者使用3种不同配方,探讨其镇痛疗效及安全性,为胆囊切除术后患者临床应用PCEA镇痛提供参考。方法:将60例(ASAⅡ级)胆囊切除手术患者随机分为3组各20例,A组应用高乌甲素和罗哌卡因,B组应用曲马多、罗哌卡因,C组应用吗啡、罗哌卡因。结果:3组术后镇痛效果比较,A组较B、C两组有显著性差异(P<0.05),B、C两组无显著性差异(P>0.05);3组术后镇痛副作用(恶心呕吐、嗜睡头昏、皮肤瘙痒、尿潴留及低血压)发生率,C组高于A、B两组;肠蠕动、恢复肛门排气时间A、B两组优于C组,A、B两组无显著差异,较C组有显著差异。结论:选择硬膜外镇痛,曲马多临床效果较佳。

Objective：To explore the analgesic efficacy and safety for the clinical application of patients after cholecystectomy analgesia PCEA to provide a reference, using of patient-controlled epidural analgesia （PCEA） technique, the use of cholecystectomy in patients with three different formulations： Methods：60 cases （ASA Ⅱgrade） cholecystectomy were randomly divided into 3 groups.A group （n = 20）： with Lappaconitine and ropivacaine; B group （n = 20）： tramadol, Ropivacaine; C group （n = 20）： morphine, ropivacaineo Results： Comparison of analgesic effects of the three groups A group than in B, C there was significant difference between the two groups （P 〈 0.05）, B, C no significant difference between the two groups （P〉 0.05）. Three groups the incidence of postoperative analgesia side effects： nausea, vomiting, drowsiness, dizziness, skin itching, urinary retention and hypotension, C is higher than A.B groups, bowel movements, anal exhaust time to restore A.B the two groups 〈C group. A.B was no significant difference between the two groups, with the C group were significantly different.Conclusion：Epidural analgesia, tramadol group was good with a better analgesic effect.