不同镇痛方法用于剖宫产患者术后镇痛的临床观察

Clinical observation on the effect of different analgesia methods for patients after cesarean section analgesia

目的:探讨不同镇痛方法用于剖宫产患者术后镇痛的临床效果。方法:2012年5月-2014年3月收治剖宫产患者126例,ASAⅠ~Ⅱ级,均为初产妇,无妊娠并发症及肝肾及血液系统疾病,随机分成观察组和对照组各63例。两组在剖宫产过程中均连续硬膜外麻醉。在术后镇痛方式不一样,观察组采用硬膜外自控镇痛泵进行镇痛,对照组于手术结束时经硬膜外导管注入镇痛液进行镇痛。结果:观察组术后4小时镇痛视觉模拟评分(0.5±0.2)分,镇痛评分(1.0±0.3)分;术后24小时镇痛视觉模拟评分(0.3±0.1)分,镇痛评分(1.4±0.2)分;术后48小时镇痛视觉模拟评分(0.2±0.1)分,镇痛评分(1.8±0.5)分。对照组术后4小时镇痛视觉模拟评分(1.2±0.8)分,镇痛评分(0.8±0.4)分;术后24小时镇痛视觉模拟评分(3.4±1.2)分,镇痛评分(0.5±0.3)分;术后48小时镇痛视觉模拟评分(2.2±0.8)分,镇痛评分(1.6±0.6)分。两组4~24小时比较差异有统计学意义(P<0.05)。观察组镇痛优良率98.4%,对照组优良率44.4%,两组比较差异有统计学意义(P<0.05)。结论:术后采用硬膜外自控镇痛泵进行镇痛,效果显著,值得推广。

Objective:To explore the clinical effect of different analgesia methods for patients after cesarean section analgesia.Methods:126 cases with cesarean section were selected from May 2012 to March 2014 with ASAⅠ to Ⅱ.They were all primipara.There were no complications of pregnancy and liver and kidney and blood system diseases.They were randomly divided into the observation group and the control group with 63 cases in each.We used the continuous epidural anesthesia in two groups of mothers in the process of cesarean section.Analgesia after surgery was not the same.The observation group were treated with epidural analgesia pump,and the control group were treated with analgesic liquid injected from the epidural catheter after the operation.Results:In the observation group,at 4 hours after operation,the visual analogue score of analgesia was(0.5±0.2),and the analgesia score was(1±0.3).At 24 hours after operation,the visual analogue score of analgesia was(0.3±0.1),and the analgesia score was(1.4±0.2).At 48 hours after operation,the visual analogue score of analgesia was(0.2±0.1),and the analgesia score was(1.8±0.5).In the control group,at 4 hours after operation,the visual analogue score of analgesia was(1.2±0.8),and the analgesia score was(0.8±0.4).At 24 hours after operation,the visual analogue score of analgesia was(3.4±1.2),and the analgesia score was(0.5±0.3).At 48 hours after operation,the visual analogue score of analgesia was(2.2±0.8),and the analgesia score was(1.6±0.6).Two groups of 4 to 24 hours were significantly different(P<0.05).In the observation group,the excellent and good rate of analgesia was 98.4%,while the excellent and good rate was 44.4% in the control group,and the difference was statistically significant(P<0.05).Conclusion:The effect of the patient controlled epidural analgesia pump for analgesia after surgery is significant,and it is worth popularizing.