两种硬膜外间隙输注技术用于术后镇痛的效果比较

Comparative analysis of two epidural space infusion techniques for postoperative analgesia

目的研究硬膜外脉冲输注(PIEB)与硬膜外持续输注用于外科术后镇痛效果的对比研究。方法选取2017至2018年腹部或下肢手术后镇痛患者100例,随机分为试验组和对照组,每组50例。试验组给予硬硬膜外脉冲输液,对照组给予持续硬膜外脉冲输注。3 h、6 h、12 h、36 h及48 h术后对比观察2组患者的生活功能、NRS疼痛评分、Bromoge评分、镇痛次数、镇痛总持续时间及药物不良反应。结果2组关于心率、血氧等生命体征的监测差异无统计学意义(P>0.05),试验组疼痛程度低于对照组(P<0.05);试验组术后不良反应发生率为6%,对照组为8%,均低于对照组,试验组具有更高的安全性(P<0.05),同时试验组的镇痛的持续时间比对照组长,试验组的自控加压频率低于对照组,2组间差异有统计学意义(P<0.05)。结论PIEB镇痛效果优于硬膜外持续背景输注。

Objective To investigate comparatively the postoperative analgesia effects between continuous epidural space pulse infusion technique(PIEB)and epidural continuous background infusion technique.Methods One hundred patients who received postoperative analgesia after abdominal or lower limb surgery in our hospital from 2017 to 2018 were enrolled in the study,who were randomly divided into experimental group and control group,with 50 cases in each group.The patients in experimental group were treated by PIEB,however,the patients in control group were treated by continuous epidural background infusion.At 3h,6h,12h,36h and 48h after operation,the vital signs,NRS analgesia score,Bromoge score,analgesia times,total duration of analgesia,and the incidence rates of complications or adverse drug reactions were observed and compared between the two groups.Results There were no significant differences in heart rate and blood oxygen saturation indexes between the two groups(P>0.05).The pain scores in experimental group were significantly lower than those in control group(P<0.05).The incidence rate of postoperative adverse reactions in experimental group was 6%,which was significantly lower than that(8%)in control group(P<0.05).Moreover the duration of analgesia in experimental group was significantly longer than that in control group,but,the auto-control compression frequency in experimental group was significantly lower than that in control group(P<0.05).Conclusion The analgesic effects of PIEB are superior to those by epidural continuous background infusion.