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开胸术后两种镇痛方式对比分析 被引量：1

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摘要 目的对比分析硬膜外自控镇痛(PCEA)和静脉自控镇痛(PCIA)两种镇痛方式对开胸手术患者术后镇痛效果和不良反应。方法择期全身麻醉下行开胸手术患者1188例,ASAⅠ～Ⅱ级,依镇痛方式不同分为PCEA组(n=1002)和PCIA组(n=186)。观察围术期两组患者镇痛效果、不良反应及术后康复情况。结果 PCEA组术后2 h静止状态下评分[(1.8±0.9)分]和术后24 h活动状态下VAS评分[(3.2±0.6)分]低于PCIA组(P<0.05);PCEA组术后24 h的Ramsay评分[(2.5±1.2)分]低于PCIA组(P<0.05)。PCEA组肺部并发症发生率(8.98%)、切口感染率(1.40%)和术后谵妄发生率(0.60%)低于PCIA组(P<0.01);两组心率失常发生率比较差异无统计学意义。结论两种镇痛方式均可达到满意的镇痛效果,但PCEA不良反应较少,更利于开胸手术患者的术后镇痛和康复。
作者 王成果 李雅兰
机构地区 广州暨南大学第一临床医学院华侨医院麻醉科
出处 《临床医学》 CAS 2013年第5期52-54,共3页 Clinical Medicine
关键词 硬膜外自控镇痛 静脉自控镇痛 开胸手术 镇痛
分类号 R614 [医药卫生—麻醉学]
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参考文献9

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同被引文献19

  • 1金荒漠,郭向阳.超声引导下周围神经阻滞技术新进展[J].中国继续医学教育,2011,3(10):51-58. 被引量：7
  • 2李挺,许爱军,徐旭仲.超声引导技术与神经阻滞[J].国外医学（麻醉学与复苏分册）,2004,25(6):372-374. 被引量：24
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  • 4Guay J. The benefits of adding epidural anakgesia to gen- eral anesthesia : A metaanalysis[J]. J Anesth, 2006,20 (4) : 335-340.
  • 5Davies RG, Myles PS, Graham JM. A comparison of the analgesic efficacy and side-effects of paravertebral vs. epidural blockade for thoracotomy-A systematic review and meta-analysis of randomized trials[J]. Br J Anaesth, 2006,96(4) :418-426.
  • 6Pintaric TS,Potocnik I,Hadzic A,et al. Comparison of continuous thoracic epidural with paravertebral block on perioperative analgesia and hemodynamic stability in pa- tients having open lung surgery[J]. Reg Anesth Pain Med, 2011,36(3) : 256-260.
  • 7Schnabel A, Reichl SU, Kra nke P, et al. Efficacy and safety of paravertebral blocks in breast surgery:A meta- analysis of randomized controlled trials[J]. Br J Anaesth, 2010,105(6) : 842-852.
  • 8Luyet C, Herrmann G, Ross S, et al. Ultrasound-guided thoracic paravertebral pincture and placement of catheters in human cadavers:Where do cathetera go?[J]. Br J Anaesth, 2011,106(2) : 246-254.
  • 9Renes SH, Bruhn J,Gielen MJ,et al. In-plane ultrasound- guided thoracic paravertebral block: A preliminary report of 36 cases with radiologic confirmation of catheter posi- tion[J]. Reg Anesth Pain Med,2010,35(2)i212-216.
  • 10陈彦青,郑春英,戴双波.星状神经节阻滞联合改良颈部椎旁神经阻滞治疗颈源性头痛[J].临床麻醉学杂志,2009,25(11):955-956. 被引量：19

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二级引证文献13

临床医学
2013年 第5期

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