一次性术后局部麻醉镇痛系统与静脉自控镇痛泵对常规开胸术后镇痛效果和安全性的比较

发布时间：2018-03-09 17:04

本文选题：局部麻醉镇痛　切入点：静脉自控镇痛　出处：《海军医学杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的研究一次性术后局部麻醉镇痛系统与静脉自控镇痛泵对常规开胸术后镇痛效果和安全性。方法将2013年6月至2014年6月在解放军第二炮兵总医院胸外科行常规开胸手术的80例患者纳入研究,经患者知情同意,签署知情同意书后运用随机数字表法分为局部麻醉镇痛系统组(试验组)与静脉自控镇痛泵组(对照组),每组40例。比较2组患者术后镇痛效果(疼痛视觉模拟(VAS)评分及Prince-Henry评分]、哌替啶累积用量、不良反应发生率。研究方案经医院伦理委员会讨论并通过。结果 (1)疼痛程度:术后12、24、48 h时,试验组患者的VAS评分(3.82±0.64,2.66±0.45,1.89±0.24)与对照组(3.71±0.77,2.74±0.55,1.94±0.51)差异无统计学意义(P0.05);Prince-Henry评分(2.39±0.34,1.48±0.18,0.92±0.11)低于对照组(3.14±0.42,2.74±0.33,1.58±0.21),差异有统计学意义(P0.05);(2)哌替啶累积使用剂量:试验组的哌替啶累积使用剂量少于对照组;(3)试验组患者术后肺不张、呼吸衰竭、恶心、呕吐、眩晕、嗜睡的发生率低于对照组患者。结论相比静脉自控镇痛泵,一次性术后局部麻醉镇痛系统能够取得更为理想的动态镇痛效果,减少阿片类药物的使用剂量以及不良反应的发生率,是更为安全有效的镇痛方法。
[Abstract]:Objective to study the analgesic effect and safety of local anaesthetic analgesia system and intravenous analgesia pump after conventional thoracotomy. Methods from June 2013 to June 2014, routine analgesia was performed in chest surgery of the second Artillery General Hospital of the people's Liberation Army. Eighty patients undergoing thoracotomy were included in the study. With the informed consent of the patient, After signing the informed consent, the patients were randomly divided into two groups: the experimental group (experimental group) and the patient controlled intravenous analgesia pump group (40 cases in each group). The postoperative analgesic effect (visual simulation of pain) was compared between the two groups. Vas score and Prince-Henry score], pethidine cumulative dosage, Incidence of adverse reactions. The study was discussed and approved by the Hospital Ethics Committee. Results 1) pain level: 124h after operation, The VAS score of the patients in the trial group was 3.82 卤0.64V 2.66 卤0.45U 1.89 卤0.24) and that in the control group was 3.71 卤0.77U 2.74 卤0.55n 1.94 卤0.51). There was no significant difference in the VAS score between the trial group and the control group. The cumulative dose of pethidine in the trial group was lower than that in the control group (2.39 卤0.34 卤1.48 卤0.180.92 卤0.11), which was significantly lower than that in the control group (3.14 卤0.42 卤2.74 卤0.33 卤1.58 卤0.21). The cumulative dose of pethidine used in the trial group was lower than that in the control group. The cumulative dose of pethidine in the trial group was lower than that in the control group. The patients in the trial group had postoperative atelectasis, The incidence of respiratory failure, nausea, vomiting, vertigo and lethargy was lower than that in the control group. Reducing the dosage of opioid and the incidence of adverse reactions is a more safe and effective analgesic method.
【作者单位】：解放军第二炮兵总医院胸外科;
【分类号】：R614

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