不同背景剂量的食管癌术后硬膜外镇痛效果的对比

Comparison of efficacy of Epidural analgesia of different dosage after esophageal cancer sugery

目的:对比不同背景剂量硬膜外镇痛在食管癌根治术中应用效果。方法:87例食管癌根治术患者随机分为A、B两组,A组57例,镇痛泵配以两个100ml容量的,单个背景剂量都是2ml/h,以三通管并联后接入硬膜外导管,B组30例,镇痛泵配以一个100ml容量的,背景剂量2ml/h,术毕接镇痛泵,术后第2天、第3天随访,以视觉模拟评分法(VAS)观察镇痛效果。结果:A组无明显不适,能主动咳痰,B组切口轻微疼痛,咳痰时疼痛加重,都不愿咳痰,A组镇痛优良率明显大于B组(P<0.05)。结论:硬膜外镇痛泵规格、种类不一,有机械泵、电子泵,常用的机械泵有2ml/h/100ml的,有4ml/h/200ml的,对食管癌这种创伤大的两切口或三切口手术,4ml/h的背景剂量的硬膜外镇痛优于2ml/h的。

Objective：Efficacy comparison of different dosage of Epidural analgesia in esophageal cancer surgery. Methods：87 patients undergoing esophageal cancer surgery were divided into group A and B.57 cases in group A were given two 100ml Analgesia pump, background dosage 2ml/h respectively, parallel three-limb tube was connected to Epidural catheter. 30cases in group were given one100ml Analgesia pump,background dosage is 2ml/h, analgesia pump was used after surgery. Followup visits were performed. VAS was used to observe the efficacy.Results：no obvious discomfort in Th in group A, capable of Active expectorating, so they are reluctant to expectorating. expectoration.Group B patients report mild pain, severer while Analgesia efficacy of group A is significantly better than group B （P〈0.05）. Conclusion：epidural analgesia pumps have various specification and classification, such as mechanical and electronic pump, and common mechanical pumps have 2ml/h/100ml and 4ml/h/200ml. For esophageal cancer surgery with severe trauma, 4ml/h background dosage of epidural analgesia is more favorable than 2ml/h.