不同全身麻醉方式对直肠癌术后静脉自控镇痛的影响

Influence of different anesthesia methods on patient-controlled intravenous analgesia after resection of rectal cancer

目的观察不同全身麻醉方式对直肠癌患者术后静脉自控镇痛(PCIA)效果的影响。方法选择行直肠癌根治术的患者60例并随机分为3组。A组:异丙酚+七氟醚+维库溴铵;B组:异丙酚+芬太尼+七氟醚+维库溴铵;C组:异丙酚+芬太尼+维库溴铵。比较3组患者在术后3、6、12、24、48 h疼痛视觉模拟评分(VAS评分)及镇静程度评分(Ramsay评分),观察48 h内PCIA按压次数及有效次数、地佐辛和芬太尼累计消耗量、患者总体满意度及不良反应发生情况。结果 3组在术后各时间点的疼痛VAS评分、镇静Ramsay评分以及芬太尼总量比较差异均有统计学意义(P<0.05)。结论不同全身麻醉方式对直肠癌根治术术后PCIA镇痛效果有一定影响。

Objective To observe the influence of different anesthesia methods on postoperative patient- controlled intravenous analgesia（ PCIA） in patients with resection of rectal cancer.Methods Sixty patients with rectal cancer were selected and randomly divided into 3 groups,20 cases in each group. Group A was treated with propofol,sevoflurane and vecuronium. Group B was treated with propofol,fentanyl,sevoflurane and vecuronium. Group C was treated with propofol,fentanyl and vecuronium. Visual analogue score（ VAS） and sedation score（ Ramsay） were compared at the time points of 3,6,12,24,48 hours after operation among the three groups,and the number of PCIA press the effective PCIA press,cumulative consumption of dezocine and fentanyl,satisfactory degree and adverse reactions were observed. Results There were significant differences of VAS,Ramsay and statistical significance in the 3 groups at each time point after operation pain VAS score,Ramsay score and cumulative consumption of fentanyl at the different time points after operation among the three groups（ P〈0. 05）. Conclusion Different anesthesia methods show certain impacts on PCIA efficacy after resection for rectal cancer.