术前HANS对剖宫产术中及术后病人的镇痛作用

PREOPERATIVE HANS STMULATION AND ITS EFFECT ON POSTOPERATIVE PAIN IN PATIENTS UNDERGOING CESAREAN SECTION

目的 :观察术前应用韩氏穴位神经刺激仪 (HANS)对术后病人自控硬膜外镇痛 (PCEA)效果、镇痛药用量及不良反应的影响。方法 :选取ASAⅠ级剖宫产产妇40例。HANS组 (HANS +PCEA组 ) 2 0例 :术前应用HANS且术后进行PCEA ;对照组 (PCEA组 ) 2 0例 :单纯术后PCEA。HANS采用DD波 ( 2 / 1 0 0Hz)刺激 30min后切皮。记录切开腹膜、分离膀胱反折、婴儿娩出、清理宫腔、探查附件、术后 6h、1 2h、2 4h各时点的疼痛评分及术后PCEA用药量 ,并观察并发症发生情况。结果 :HANS组各时点疼痛评分低于对照组 ,有统计学差异。HANS组术后镇痛药用量比对照组减少1 9% ,但无统计学显著性 ,HANS组恶心呕吐发生率显著低于对照组。结论 :术前应用HANS可增加术中及术后镇痛效果 。

Aim: To observe the effects of pre operative HANS on the dose of the patient controlled epidural analgesia (PCEA) and aversive side effects of PCEA, 40 ASA I patients undergoing Cesarean section were randomly divided into two groups: HANS group (20 cases) was given HANS preoperatively and PCEA postoperativly; control group (20 cases) was given PCEA only. For HANS stimulation, 2/100Hz wave was used for 30 minutes. The VAS score was recorded in eight time points (opening peritoneum; detaching peritoneum between uterus and bladder; fetal delivery; clearing cavity of uterus; exploring adnexa; 6 h, 12 h and 24 h after the operation), the doses of analgesics and complications were also observed. Results: HANS group had significantly less VAS scores than the control group. The dose of analgesics used in HANS group was not significantly less than the control group. The incidence of nausea and vomiting was significantly less in HANS group. Conclusion: preoperative use of HANS reduces pain during and after operation, and reduces the incidence of nausea and vomiting.