上肢手术后不同镇痛方法的效果比较

The Comparison of Different Analgesia Methods Following the Upper Extremity's Surgery

目的 :寻求一种上肢手术后镇痛效果好 ,方法简便 ,全身不良反应少的镇痛方法。方法 :选择上肢手术病人 4 0例 ,随机分为Ⅰ、Ⅱ两组 ,每组 2 0例 ,两组术后予PCA(自控镇痛 )泵镇痛 ,输注速率 2 .0ml/h ,Ⅰ组采用连续臂丛阻滞镇痛 0 .15 %罗哌卡因 +地塞米松 0 .1mg/ml,Ⅱ组采用静脉镇痛吗啡 0 .4mg/ml+地塞米松 0 .1mg/ml+氟哌利多 0 .0 5mg/ml。两组均记录术后VAS(视觉模拟 )评分 ,镇静程度及不良反应。结果 :两组VSA评分无明显差异 (P >0 .0 5 ) ,Ⅱ组镇静程度优于Ⅰ组(P <0 .0 1) ,但不良反应明显高于Ⅰ组。结论 :连续臂丛阻滞用于上肢手术术后镇痛 ,方法简便 ,效果确切。

Objective: To investigate one analgesic method following the upper extremity's surgery which is simple and convenient and has few bad side effect of the whole body. Methods: 40 cases undergoing the upperextremity's surgery were randomly divided into two groups. groupⅠ(n=20)and groupⅡ(n=20), both were adminstated PCA pump at the rate of 2 ml/h after operation.Group Ⅰ adopted continued braehial plexus block analgesia 0.15% ropivacaine+dexamethasone 0.1 mg/ml, while group Ⅱ adopted patient-controlled intravenous analgesia morphine 0.4 mg/ml+dexamethasone 0.1 mg/ml+droperidole 0.05 mg/ml. postoperative VSA. Sedation degree and side effect were recorded. Results: There were no significant difference in VSA of both groups(P>0.05), but group Ⅱ was superior in sedate degree to that of group Ⅰ(P<0.01), and side effect of groupⅡwas higher than that of groupⅠ obviously. Conclusion:continuous braehial plexus block analgesia used following the upper extremity's surgery is exactly simple and convenient.