单次硬膜外镇痛联合静脉自控镇痛在初产妇剖宫产术后患者中应用效果研究

Clinical efficacy of single epidural analgesia combined with pure vein controlled analgesia after cesarean section surgery in primipara

目的:探讨单次硬膜外镇痛联合静脉自控镇痛运用于剖宫产术后初产妇的镇痛效果和安全性。方法:随机将2009年12月～2011年12月我院住院行剖宫产的120例初产妇分为两组,即对照组和治疗组,对照组初产妇采用硬膜外镇痛方式进行镇痛,而治疗组初产妇则在上述硬膜外镇痛的基础上加用单纯静脉自控镇痛,比较两组初产妇剖宫产术后1、6、12h及24h时这4个时间点的痛觉视觉模拟评分(VAS),同时,比较两组患者恶心呕吐、呼吸抑制、皮肤瘙痒、尿潴留等不良反应的发生率。结果:两组初产妇在呼吸抑制、恶心呕吐、皮肤瘙痒和尿潴留发生率方面差异无统计学意义(P>0.05),但是治疗组初产妇VAS在6h这1时间点上明显低于对照组初产妇,差异有统计学意义(P<0.05),且治疗组初产妇对镇痛的满意度明显高于对照组(P<0.05)。结论:单次硬膜外镇痛联合静脉自控镇痛效果显著优于硬膜外镇痛,安全有效,不良反应少,值得进一步推广。

Objective. To evaluate the clinical efficacy and safety of single epidural analgesia com- bined with pure vein controlled analgesia in primipara after cesarean section surgery. Methods： One hun- dred and twenty primipara underwent cesarean section surgery in our hospital from December 2009 to De- cember 2011 were randomly divided into the control group and observation group. Primipara in the control group was given single epidural analgesia, but the observation group was given single epidural analgesia combined with pure vein controlled analgesia. Pain visual analogue scale （VAS）, incidence of nausea and vomiting, respiratory inhibition, pruritus and urinary retention at 4 time points including l h, 6h, 12 h and 24 h after the surgery were compared between the two groups. Results. There were no significant differ- ences in incidence of nausea and vomiting, respiratory inhibition, pruritus and urinary retention between the two groups （P〉0.05）, but pain visual analogue scale in the observation group were significant lower than that in the control group 6 hours after undergoing the surgery （P〈0.05）. Besides, analgesic satisfac-tion in the observation group were higher than that in the control group 6 h after undergoing the surgery （P（0.05）. Conclusion： The clinical efficacy of single epidural analgesia combined with pure vein controlled analgesia in primipara after cesarean section surgery is superior to single epidural analgesia. It is safe and reliable thus is worthy of clinical application.