术后硬膜外镇痛泵的临床应用与疗效观察

Clinical application of epidural analgesia for postoperative pain relief

目的 :本文观察术后病人使用硬膜外自控镇痛泵 (PCEA)和持续镇痛泵 (CEA)的方法和临床效果。方法 :6 0例ASAI-II级腹部手术患者 ,随机分为二组 :A组 (PCEA组 ) 30例 ,吗啡 1 5mg、氟哌利多 5mg、布比卡因 1 5 0mg +0 .9%NS至 1 0 0ml。持续量 1ml/h ,PCA量 0 .5ml/次 ,安全锁定时间1 5min。B组 (CEA组 ) 30例 ,吗啡 1 0mg、氟哌利多 5mg、布比卡因 1 5 0mg、+0 .9%NS至 1 0 0ml。持续量2ml/h。均于手术结束时将镇痛泵于硬膜外导管连接 ,观察并记录疼痛评分、SpO2 、呼吸频率、血压、镇静状态及恶心呕吐等指标。结果和结论 :二组病人上述观察指标无显著性差异 ,疼痛控制率均达98%。

Objective: To investigate and compare the clinical effects of patient controlled epidural analgesia (PCEA) and continuous epidural analgesia (CEA) for postoperative pain relief. Method: 60 ASA I-II patients undergoing abdomen operation were randomly divided into two groups: PCEA group (n=30) with morphine 15 mg + droperidol 5 mg + bupivocaine 150 mg + 0.9% NS to volume 100 ml, basal infusion 1 ml/h + bolus 0.5 ml, lockout time 15 min; CEA group (n=30) with morphine 10 mg + droperidol 5 mg + bupivocaine 150 mg + 0.9% NS to volume 100 ml at infusion rate 2 ml/h. Postoperative epidural pain relief was started at the end of operation. Patients were visited postoperatively and recorded pain scores, SpO 2, respiratory rate, blood pressure, sedition status, and side effects such as nausea, vomiting, pruritus, urine retention, etc. Result and Conclusion: There were no statistical significant differences in all these observe indexes between PCEA and CEA group. PCEA and CEA patients achieved a 98% satisfactory pain control rate and were equally effect for postoperative pain.