不同麻醉方式对胃癌根治术后患者疼痛程度的影响

Comparison of degree of pain in patients after radical gastrectomy under different anesthetic regimens

目的比较全麻和全麻联合硬膜外阻滞麻醉对胃癌根治术后患者疼痛程度的影响。方法将60例行胃癌根治术的患者随机分为单纯全麻组(CA组)和全麻联合硬膜外阻滞组(CGEA组),每组30例,比较两组患者术后不同时间点的VAS评分、术后12 h阿片类镇痛药使用量及不良反应发生率。结果 CGEA组术后1 h、4 h、8 h、12 h及24 h疼痛程度评分均明显低于同期CA组疼痛程度评分(均P<0.05)。术后12 h,CGEA组重度疼痛发生率、吗啡用量明显低于GA组(P<0.01,P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论全麻联合硬膜外阻滞麻醉可显著降低胃癌根治术后患者的疼痛程度,减小吗啡等镇痛药用量,效果安全可靠,是胃癌根治手术患者较为一种理想的复合麻醉方式。

Objective To compare the degree of pain in patients after radical gastrectomy under anes- thesia and general anesthesia combined with epidural anesthesia. Methods 60 cases of gastrectomy patients were randomly divided into anesthesia alone group （CA group） and general anesthesia combined with epidural anesthesia group （CGEA group）, with 30 cases in each group, VAS scores of different time points postopera- tively, the dosage of opioid 12 h after surgery and adverse reaction rate of the two group were compared. Results 1 h, 4 h, 8 h, 12 h and 24 h after surgery, pain severity score of CGEA group were significantly lower than that in the CA group （P 〈0. 05）. 12 h after surgery, the incidence of moderate to severe pain, morphine con- sumption in the CGEA group were significantly lower than that in the GA group （ P 〈 0. 01, P 〈 0. 05 ） ; there was no statistically significance on the incidence of adverse reactions between the two groups （ P 〉 0. 05 ）. Con- ehmion Anesthesia combined with epidural block anesthesia can significantly reduce gastric cancer degree of postoperative pain, reduce the amount of morphine and other analgesics, with safe and reliable effect, which is an ideal composite anesthesia for gastric cancer surgery.