腹部手术后镇痛药需求量的影响因素

Factors affecting analgesia requirements after abdominal surgery

目的：分析腹部手术后患者自控静脉镇痛用药量的影响因素。方法选取2012年4月至2013年8月全麻下行腹部手术，术后接受48 h自控静脉镇痛的患者。记录患者性别、年龄、身高、体重、体重指数、手术方式、手术部位。术后静脉镇痛期间，记录用药剂量、静止和运动疼痛评分、镇静评分、心率、血压、脉搏氧饱和度以及不良反应。采用多元线性回归分析多个变量与用药量的关系。结果共有2829例（男性1611例，女性1218例）患者纳入分析。性别、年龄、体重和手术部位显著影响术后镇痛用药量。其中，体重影响最大且与术后镇痛用药量正相关，年龄与术后镇痛用药量负相关，女性用药量少于男性。身高、体重指数和手术方式不是术后镇痛用药量的决定因素。结论腹部手术患者实施术后自控静脉镇痛时要考虑体重、年龄、性别以及手术部位的影响，为患者制定专科化和个体化的镇痛方案。

Objective To investigate the factors affecting patient-controlled intravenous analgesia （PCIA）requirements after abdominal surgery.Methods Patients receiving surgery under general anesthesia with PCIA for 48 hours during the period between April 2012 and August 2013 were included.Patient data including sex,age,height,weight,body mass index（BMI）,operation type and site were collected.To-tal analgesia consumption,pain scores at rest and during movement,sedation score,heart rate,blood pres-sure,oxygen saturation and adverse reactions were recorded during the PCIA course.Multiple linear regres-sion analyses were conducted to select factors significantly associated with analgesia consumption.Results A total of2829 patients（1611 men,1218 women）were included in the analysis.Sex,age,weight and operation site were significantly associated with analgesia consumption.Among them,weight was the most important factor and it＇s positively correlated with total analgesia requirement.Age was negatively correlated with analgesia requirement and women required less analgesia than men.Height,BMI and operation type were not determinative factors of PCIA requirement.Conclusion The influence of weight,age,sex and operation site on PCIA after abdominal surgery should be considered.Specialized analgesic procedure should be designed for each individual patient.