静脉自控镇痛与硬膜外自控镇痛在剖宫产术后的应用效果比较

Comparison of Application Effect between Patient-controlled Intravenous Analgesia and Patient-controlled Epidural Analgesia after Cesarean Section

目的:比较静脉自控镇痛与硬膜外自控镇痛在剖宫产术后的应用效果。方法:选取2020年1月-2021年3月于本院收治的行剖宫产术的60例产妇作为研究对象,将其随机分为对照组(30例)和观察组(30例)。对照组采取静脉自控镇痛,观察组采用硬膜外自控镇痛。比较两组术后1、8、24 h的VAS评分、Ramsay镇静评分,并检测血清泌乳素浓度,记录不良反应的发生情况。结果:术后1 h,两组的VAS评分比较,差异无统计学意义(P>0.05);术后8、24 h,观察组的VAS评分均低于对照组(P<0.05)。术后1 h,两组的Ramsay镇静评分比较,差异无统计学意义(P>0.05);术后8、24 h,观察组的Ramsay镇静评分均低于对照组(P<0.05)。观察组术后24、48 h血清泌乳素浓度均明显高于对照组(P<0.05)。观察组不良反应发生率为10.00%,低于对照组的26.67%(P<0.05)。结论:硬膜外和静脉自控镇痛都具有较好的剖宫产术后镇痛效果,但硬膜外自控镇痛的镇痛、镇静效果更佳,且安全性良好,值得临床推广。

Objective:To compare the application effect of patient-controlled intravenous analgesia and patient-controlled epidural analgesia after cesarean section.Method:A total of 60 pregnant women underwent cesarean section in our hospital from January 2020 to March 2021 were selected as the study objects,they were randomly divided into control group(30 cases)and observation group(30 cases).Patient-controlled intravenous analgesia was used in the control group and patient-controlled epidural analgesia was used in the observation group.VAS scores and Ramsay sedation scores at 1,8 and 24 h after operation were compared between the two groups,serum prolactin concentration was detected,and the occurrence of adverse reactions was recorded.Result:1 h after surgery,there was no significant difference in VAS scores between the two groups(P>0.05);VAS scores of observation group were lower than those of control group at 8 and 24 h after operation(P<0.05).There was no significant difference in Ramsay sedation score between the two groups at 1 h after surgery(P>0.05);Ramsay sedation scores of the observation group were lower than those of the control group at 8 and 24 h after operation(P<0.05).The serum prolactin concentration in observation group were significantly higher than those in control group at 24 and 48 h after operation(P<0.05).The incidence of adverse reactions in observation group was 10.00%,lower than 26.67%in control group(P<0.05).Conclusion:Both patient-controlled epidural analgesia and patient-controlled intravenous analgesia have good analgesic effects after cesarean section,but patient-controlled epidural analgesia has better analgesic and sedative effects and good safety,which is worthy of clinical promotion.