病人自控镇痛术用于开胸手术后的效果

PATIENT-CONTROLLED ANALGESIA FOR POSTTHORACOTOMY

1目的 评价病人自控镇痛方法 (PCA)用于开胸手术后的效果 ,并探讨氟哌利多对哌替啶作用的影响。 2方法 选择 40例在全麻下开胸手术的 ASA ～ 级病人 ,手术后随机双盲分为哌替啶组 (P组 )和哌替啶、氟哌利多组 (PD组 ) ,采用英国 Graseby- 930 0便携式 PCA注射泵及一次性药盒行 PCA ,对比观察至术后 48h.3结果 两组均得到较好镇痛效果且 VAS疼痛评分相仿 ,咳痰效果好 ;镇静评分 PD组较 P组高 ,差异有极显著意义(t=3.5 0 7,P<0 .0 1)。 PD组哌替啶用量较 P组明显减少 (t=2 .40 4～ 4.76 2 ,P<0 .0 5 ,0 .0 1) ,并且两组术后 0～ 8h每小时平均用量均较 9～ 2 4h每小时平均用量少 (t=2 .2 5 1,3.6 5 8,P<0 .0 5 ,0 .0 1)。4结论 PCA是开胸手术后理想的镇痛方法 ,氟哌利多可减少 PCA的哌替啶用量 ,降低恶心。

Objective\ To assess the analgesic effect of patient controlled analgesia (PCA) in postthoracotomy pain and to compare the analgesic effect between pethidine group and pethidine with droperidol group.\ Methods\ Fourty patients (ASA statge 1 or 2) undergoing thoracotomy with general anesthesia were randomly assigned to two groups after operation, group P: 2.5 g/L pethidine only, group PD: 2.5g/L pethidine with 0.05g/L droperidol. Graseby 9300 portable PCA was used. Postoperation monitoring continued to 48 hrs.\ Results\ Both groups obtained adeouate pain relief with similar VAS score. The consumption of pethidine in group PD was lower than that in group P( t=2.406-4.762,P <0.05,0.01),and sedative scores were higher in group PD than in group P( t=3.507, P <0.01). The drug comsumption in both groups during 0-8h was lower than that during 9-24h( t=2.251,3.658,P <0.05,0.01).\ Conclusion\ PCA with pethidine combined with droperidol is safe and effective analgesia method for postthoracotomy. [