不同镇痛方法对术后肠功能的影响

Different Demulcent Methods of Postoperative Effects of Bowel Function

目的探讨布比卡因硬膜外镇痛对胃肠手术后肠功能的影响。方法 500例胃肠手术患者按随机原则分为两组,对照组采取常规哌替啶肌注镇痛;观察组术后行布比卡因混合吗啡硬膜外镇痛,分析术后两组患者的临床镇痛疗效以及并发症。结果硬膜外镇痛观察组在2、6、12、26h的VAS评分分别为(5.5±1.3)、(5.7±1.9)、(4.7±1.3)、(4.6±1.6)分,均显著低于对照组(P<0.05);肠功能恢复方面:观察组术后排气时间(36.7±10.9)h、肠鸣音评分为(1.6±0.6)分,均较对照组明显缩短(P>0.05);除呼吸抑制外,两组术后并发症差异无统计学意义(P>0.05)。结论硬膜外低浓度布比卡因混合吗啡用于胃肠手术后镇痛效果良好,对术后肠功能恢复具有重要意义。

Objective To study the the influence of bupivacaine epidural analgesia to bowel function after gastrointestinal surgery. Methods 500 cases gastrointestinal surgery patients were randomly divided into two groups according to the principle. The control group takes groovy Pitying muscle note analgesia; The observation group postoperative was using bupivacaine mix with morphine epidural analgesia. The two groups were analyzed postoperative clinical analgesic efficacy and complications. Results The epidural analgesia observer group in 2,6,12,26h were respectively （ 5.5 ± 1.3 ）, （ 5.7 ± 1.9 ）, （ 4.7 ±1.3 ）, （ 4.6 ± 1.6 ） in VAS score, and they were significantly lower than those of the control group （P 〈 0.05 ）. Bowel function recovered, the observation group postoperative exhausted time to （ 36.7 ± 10.9 ） h, and satisfactory sound score for （ 160 ± 0.6 ） points, which is better than the control group （ P 〉0.05 significantly reduced ） ; Except respiratory inhibition, difference of the two groups of postoperative complications was statistically significant （P 〉 0.05 ）. Conclusion Bupivacaine epidural analgesia mixed with morphine used for gastrointestinal surgery has an important significance bowel function recovery.