全身麻醉复合硬膜外麻醉对胃癌术后镇痛的影响被引量：19

Effects of different anaesthesia methods on postoperative analgesia of radical gastrectomy

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摘要目的:观察全身麻醉复合硬膜外麻醉对胃癌手术病人术后镇痛的影响。方法:90例择期行胃癌根治术患者,ASA I-II级,年龄33-60岁,随机均分为2组:G+E(全麻+硬膜外)组和G(单纯全麻)组。均采用超前镇痛和PCIA。观察术后48h内(2,4,8,24,48h)的镇痛评分(VAS),PCA使用次数,不良反应。结果:术后2,4,8h G+E(全麻+硬膜外)组的VAS评分明显低于G(单纯全麻)组(P<0.05)。术后24h内PCA按压次数G+E(全麻+硬膜外)组明显低于G(单纯全麻)组(P<0.05)。G+E(全麻+硬膜外)组的不良反应发生率明显低于G(单纯全麻)组(P<0.05)。结论:胃癌手术时应用全身麻醉复合硬膜外麻醉可以明显加强术后镇痛效果,降低不良反应。 Objective：To observe the effects of different anaesthesia methods on postoperative analgesia of radical gastrectomy.Methods：Ninety patients（ASAⅠor Ⅱ） with gastric carcinoma were randomly divided into two groups（G＋E,G）.All patients were given preemptive analgesia and PCIA.Visual analogue scale（VAS） was used to assess the pain intensity at 2,4,8,24 and 48h after surgery.Results：VAS of G＋E group at 2,4,8 hours after surgery were significantly less than G group（P0.05）.The effective press frequency of G＋E group in 24 hours after surgery was significantly less than G group（P0.05）.Adverse reaction of G＋E group was significantly less than G group（P0.05）.Conclusion：General anaesthesia plus epidural anesthesia used in gastric carcinoma can significantly enhance the effect of postoperative analgesia and decrease adverse reaction.

作者路喻清冯阳阳史军军张向东胡彬

机构地区延安大学附属医院麻醉科子长采油厂职工医院

出处《现代肿瘤医学》 CAS 2011年第4期764-766,共3页 Journal of Modern Oncology

关键词胃癌全身麻醉硬膜外麻醉术后镇痛 gastric carcinoma general anaesthesia epidural anesthesia postoperative analgesia

分类号 R735.2 [医药卫生—肿瘤]

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参考文献9

1Kavanagh BP,Katz J,Sandler AN.Pain control after thoracic surgery:A review of current techniques[J].Anesthesiology,1994,81:737.
2Wu CL,Fleisher LA.Outcomes research in regional anesthesia and analgesia[J].Anesth Analg,2000,91:1232.
3Roberts Gregory W.B Pharm,Fshp,et al.Postoperative nausea and vomiting are strongly influenced by postoperative opioid use in a dose-related manner[J].Anesth Analg,2005,101:1343-1348.
4Takada M,Fukusaki M,Terao Y,et al.Preadministration of flurbiprofen suppresses prostaglandin production and post operative pain in orthopedic patients undergoing tourniquetinflation[J].Clin Anesth,2007,19(2):97-100.
5Sedinkin AA,Balandin AV,Dimova AD.Results of an openprospective controlled randomized comparative trial of flurbiprofen and paracetamol efficacy and tolerance in patiens with throat pain[J].Ter Arkh,2005,77(9):74-76.
6Xu Y,Tan Z,Chen J,et al.Intravenous flurbiprofen axetilaccelerates restoration of bowel function after colorectal surgery[J].Can J Anaesth,2008,55:414-422.
7沈锦春,郭海峰,杨建军,段满林,朱四海,徐建国.氟比洛芬酯联合吗啡镇痛对胃癌患者术后吗啡用药量及肠功能恢复的影响[J].临床麻醉学杂志,2009,25(5):383-386. 被引量：38
8Takada M,Fukusaki M,Terao Y,et al.Preadministration of flurbiprofen suppresses prostaglandin production and post-operative pain in orthopedic patients undergoing tourniquetinflation[J].J Clin Anesth,2007,19:97-100.
9Kaufman E,Epstein JB,Gorsky M,et al.Preemptive analgesia and local anesthesia as a supplement to general anesthesia:a review[J].Spring,2005,52(1):29-38.

二级参考文献10

1Yamashita K,Fukusaki M,Ando Y,et al.Preoperative administration of intravenous flurbiprofen axetil reduces postoperative pain for spinal fusion surgery.J Anesth,2006,20:92-95.
2Ohmukai O.Lipo-NSAID preparation.Adv Drug Deliv Rev,1996,20:203-207.
3Xu Y,Tan Z,Chen J,et al.Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery.Can J Anaesth,2008,65:414-422.
4Reuben SS,Connelly NR.Postoperative analgesic effects of celecoxib or rofecoxib after spinal fusion surgery.Anesth Analg,2000,91,1221-1225.
5Malmstrom K,Daniels S,Kotey P,et al.Comparison of rofecoxib and celecoxib,two cyclooxygenase-2 inhibitors,in postoperative dental pain:a randomized,placebo-and activecomparator-controlled clinical trial.Clin Ther,1999,21:1653-1663.
6Takada M,Fukusaki M,Terao Y,et al.Preadministration of flurbiprofen suppresses prostaglandin production and postoperative pain in orthopedic patients undergoing tourniquet inflation.J Clin Anesth,2007,19:97-100.
7Roszkowski MT,Swift JQ,Hargreaves KM.Effect of NSAID administration on tissue levels of immunoreactive prostaglandin E2,leukotriene B4,and (S)-flurbiprofen following extraction of impacted third molars.Pain,1997,73:339-345.
8Parepally JM,Mandula H,Smith QR,et al.Brain Uptake of Nonsteroidal Anti-Inflammatory Drugs:Ibuprofen,Fhirbiprofen,and Indomethacin.Pharm Res,2006,23:873-881.
9Bannwarth B,Netter P,Pourel J,et al.Clinical pharmacokinetics of nonsteroidal anti-inflammatory drugs in the cerebrospinal fluid.Biomed Pharmacother,1989,43:121-126.
10Nakayama M,Ichinose H,Yamamoto S,et al.Perioperative intravenous flurbiprofen reduces postoperative pain after abdominal hysterectomy.Can J Anaesth,2001,48:234-237.