本文選題：局部麻醉鎮(zhèn)痛　切入點(diǎn)：靜脈自控鎮(zhèn)痛　出處：《海軍醫(yī)學(xué)雜志》2016年02期 　論文類型：期刊論文

【摘要】：目的研究一次性術(shù)后局部麻醉鎮(zhèn)痛系統(tǒng)與靜脈自控鎮(zhèn)痛泵對常規(guī)開胸術(shù)后鎮(zhèn)痛效果和安全性。方法將2013年6月至2014年6月在解放軍第二炮兵總醫(yī)院胸外科行常規(guī)開胸手術(shù)的80例患者納入研究,經(jīng)患者知情同意,簽署知情同意書后運(yùn)用隨機(jī)數(shù)字表法分為局部麻醉鎮(zhèn)痛系統(tǒng)組(試驗組)與靜脈自控鎮(zhèn)痛泵組(對照組),每組40例。比較2組患者術(shù)后鎮(zhèn)痛效果(疼痛視覺模擬(VAS)評分及Prince-Henry評分]、哌替啶累積用量、不良反應(yīng)發(fā)生率。研究方案經(jīng)醫(yī)院倫理委員會討論并通過。結(jié)果 (1)疼痛程度:術(shù)后12、24、48 h時,試驗組患者的VAS評分(3.82±0.64,2.66±0.45,1.89±0.24)與對照組(3.71±0.77,2.74±0.55,1.94±0.51)差異無統(tǒng)計學(xué)意義(P0.05);Prince-Henry評分(2.39±0.34,1.48±0.18,0.92±0.11)低于對照組(3.14±0.42,2.74±0.33,1.58±0.21),差異有統(tǒng)計學(xué)意義(P0.05);(2)哌替啶累積使用劑量:試驗組的哌替啶累積使用劑量少于對照組;(3)試驗組患者術(shù)后肺不張、呼吸衰竭、惡心、嘔吐、眩暈、嗜睡的發(fā)生率低于對照組患者。結(jié)論相比靜脈自控鎮(zhèn)痛泵,一次性術(shù)后局部麻醉鎮(zhèn)痛系統(tǒng)能夠取得更為理想的動態(tài)鎮(zhèn)痛效果,減少阿片類藥物的使用劑量以及不良反應(yīng)的發(fā)生率,是更為安全有效的鎮(zhèn)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 鹵0.64V 2.66 鹵0.45U 1.89 鹵0.24) and that in the control group was 3.71 鹵0.77U 2.74 鹵0.55n 1.94 鹵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 鹵0.34 鹵1.48 鹵0.180.92 鹵0.11), which was significantly lower than that in the control group (3.14 鹵0.42 鹵2.74 鹵0.33 鹵1.58 鹵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.
【作者單位】： 解放軍第二炮兵總醫(yī)院胸外科;
【分類號】：R614

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