硬膜外联合静脉镇痛在剖宫产患者术后自控镇痛中的效果观察

Observation on effect of epidural combined with patient-controlled intravenous analgesia in patients undergone cesarean delivery

目的:探讨舒芬太尼单次硬膜外注射联合静脉自控镇痛对剖宫产术后患者的镇痛效果及不良反应。方法:选择剖宫产术后行镇痛治疗的患者40例,随机分成A、B两组,每组20例。A组行硬膜外术后镇痛,B组行舒芬太尼单次硬膜外注射联合静脉自控镇痛。比较两组患者的镇痛效果及不良反应。结果:两组患者术后VAS评分及Ramsay评分在各时间点的比较差异均无统计学意义(P均>0.05);但B组患者术后尿管留置时间短于A组[(10.20±1.77)h比(17.70±4.46)h,P<0.01],皮肤瘙痒的发生率明显低于A组(5%比30%,P<0.05)。结论:舒芬太尼单次硬膜外注射联合静脉自控镇痛用于剖宫产术后镇痛安全有效,是剖宫产术后硬膜外镇痛的一种较好的替代办法。

Objective： To evaluate the analgesic effect and the complications of epidural combined with patientcontrolled intravenous analgesia for patients undergone cesarean delivery. Methods： A total of 40 patients undergoing cesarean delivery were randomly divided into two groups with 20 cases in each group. Group A received epidural analgesia while group B was given epidural combined with patient-controlled intravenous analgesia. The analgesic effect and the complications of the two groups were compared. Results： Visual analogue scale scores（VAS） and Ramsay scores were not statistically significant between two groups at different time points post-operatively（P0.05）, but the postoperative urinary catheter indwelling time and the incidence of pruritus in group B were significant lower than those in group A（P0.01 or P0.05）. Conclusions： Our results demonstrate that epidural combined with patient-controlled intravenous analgesia provided effective and safe post-operative outcome for patients undergone cesarean delivery, and it may be a feasible alternative to epidural analgesia.