双氯芬酸钠栓剂与患者自控静脉镇痛用于剖宫产术后的镇痛效果观察

Postoperative analgesic effects of diclofenac sodium and patient-controlled intravenous analgesia inpatient′s undergoing cesarean section

目的比较直肠给予双氯芬酸钠与患者自控静脉镇痛(PC IA)在剖宫产术后的镇痛效果及不良反应。方法在硬膜外-蛛网膜下隙联合麻醉下行剖宫产术产妇120例,随机分为双氯芬酸钠栓剂组(Ⅰ组)和PC IA组(Ⅱ组),每组各60例。Ⅰ组患者在手术结束时、术后12h和24h直肠给予双氯芬酸钠栓剂,Ⅱ组患者在手术结束时给予芬太尼PC IA。采用双盲法观察并记录术后4、8、16、24、36h和48h的视觉模拟评分(VAS)、舒适度评分(BCS)及不良反应。结果术后两组VAS及BCS在各个时间点相似,但Ⅱ组术后嗜睡和呼吸抑制的发生明显高于Ⅰ组(P<0.05),Ⅰ组术后肛门刺激征发生率高于Ⅱ组(P<0.05)。结论直肠给予双氯芬酸钠用于剖宫产术后镇痛效果满意,不良反应少。

Objective To assess the analgesic efficacy of diclofenac sodium and patient-controlled intravenous alialgesia （PCIA） in patient＇s undergoing cesarean sechon. Methods One hundred-twenty patients undergoing cesarean section were randomly divided into two groups（n=60）. In group Ⅰ ,patients were received rectal adminsistration of diclofenac sodium suppository at 0h, 12h and 24h after operation. In group Ⅱ, the PCIA （fentanyl 20μg/kg combined with dropehdol 5 mg, loading dose = 2ml, background dose = 2 ml/h, bolus dose = 0. 5 ml, lockout interval = 15 min） was used. The visual ahalogue seale （ VAS）, Brugrmann comfort scale （BCS） and side effects were recorded at 4,8,16,24,36h and 48h after operation. Results There were no significant difiefences in demographic data. The VAS and BCS scores of patients in two groups were similar in die period of inveshgation. Although thee incidonce of alial stimuladng sign of group Ⅰ was much more than another group（P〈0. 05）, the incidelice of somnolence and respiratory depression of group Ⅰ were significantly lower than those of group Ⅱ （P〈0.05）. Coulusion Rectal administration of diclofenac sodium is satisfactory for postoperative alialgesia with little side eefiect in patients undergoing cesarean section.