开胸食管癌根治术后不同镇痛方法的比较及对血糖的影响

Effects of different analgesic methods on blood glucose after thoracic surgery

目的 观察开胸食管癌根治术后不同镇痛方法的镇痛效果以及血糖的变化情况 ,探讨不同镇痛方法对食管癌根治术后应激反应的影响。方法 36例行食管癌根治术患者 ,按术后镇痛方法的不同随机分为病人自控镇痛 (PCA)组和肌肉注射镇痛 (MI)组。比较两组镇痛效果 ,监测围麻醉期病人血糖的变化 ,并进行统计学分析。结果 PCA组镇痛效果优于MI组 ,前者视觉疼痛模拟评分 (VAS)低于后者 (P <0 .0 5 )。PCA组血糖浓度相对恒定 ,并且低于MI组 (P <0 .0 5 )。结论 开胸食管癌根治术后PCA镇痛效果良好 ,能有效地降低疼痛所致的应激反应 ,有助于术后恢复。

Objective To observe the influences of different analgesic methods on blood glucose after thoracic surgery.Methods Thirty six patients suffering from esophageal cancer,ASA class Ⅰ～Ⅱ,scheduled for thoracic surgery under general anesthesia,were randomly divided into two groups:PCA group and MI group.Blood glucose were determined during the perioperative period.Results In PCA group the score of visual analog scale was significantly lower than that in MI group ( P <0.05).The blood sugar concentrations were kept stable ( P <0.05) during whole procedures.Conclusions After thoracic surgery PCA can be effectively applied to inhibiting postoperative stress.