体表电刺激对硬膜外自控镇痛效应及康复质量的影响

Effects of transcutaneous electric nerve stimulation on the postoperative analgesia with PCEA and recovery after surgery

目的研究体表电刺激对硬膜外自控镇痛(PCEA)效应和患者康复质量的影响。方法选择经腹子宫切除术60例,随机分成3组,每组20例。A组:于硬膜外麻醉后切皮前、术后4、8h,体表电刺激仪各刺激30min,术后行PCEA;B组:单纯行术后PCEA;C组(对照组):不用PCEA。术后随访镇痛效果、镇痛药用量、血清皮质醇含量、焦虑情绪和患者不良反应等情况。结果PCEA组镇痛效果满意,明显优于对照组(P<0.01)。A组镇痛药用量少于B组(P<0.01),术后皮质醇浓度下降幅度大于B组。A组术后48h内患者的焦虑发生率明显低于C组。结论复合应用体表电刺激,可增强镇痛效应,改善患者的精神心理状态。

Objective To evaluate the effects of Han' s acupoint nerve stimulator(Han' s)on postoperative patient controlle d epidural analgesia(PCEA)and recovery after surgery.Method60patients of ASAⅠ-Ⅱundergoing hysterectomy were randomly divided into three groups(n=20each)according to postoperative analgesia used:group A(Han' s and PCEA);group B(PCEA only)and group C (pethidine intramuscular).The VAS score,Ramsay score,Bruggrmann comfort scale ,dosage of analge sia ,HAMA score,serum cortisol level and the times of hospital discharge were observed.Results The VAS score were lower in A and B grou ps than those in group C (P<0.01).The dosage of analgesia in group A was(31.7±1.9)ml,as compared to(34.2±2.1)ml in group B,showing a significant difference(P<0.01).The serum cortisol were decrease in both PCEA groups,but the level was lo wer in group A than in group B after operation.The ratio of anxiety in group A was lower than that in group C.The times of hospital disc harge of group A was shortest in three groups.Conclusion PCEA combined with transcutaneous electric nerve stimulation can enhance th e analgesic efficacy ,reduce analge sia dosage.