不同手术部位的术后病人自控镇痛疗效分析

THE EFFICACY OF POSTOPERATIVE PATIENT-CONTROLLED ANALGESIA AFTER DIFFERENT KINDS OF OPERATIONS

摘要:

目的 :回顾性分析不同手术部位的术后镇痛疗效及副作用。方法 :2 2 5 6例患者根据手术部位分为 10组。记录 4 8小时内的镇痛效果和副作用。结果 :各组术后VAS评分均在 3分以下。术后第一日VAS评分肺及食道组最高 ,术后第二日以头颈部最高 (组间比P <0 .0 5 )。上腹部手术组按压次数最多 ,心脏组平均有效率最低。乳腺组恶心呕吐发生率最高 (组间比P <0 .0 5 ) ,肺及食道组血压波动和呼吸抑制发生最多。结论 :常用的硬膜外或静脉病人自控镇痛方法镇痛效果明确 ,手术创伤较大者术后镇痛可以在密切监护下适当增加剂量 ,镇痛前给予止吐药可以预防和减少恶心呕吐等副作用的发生。

Abstract:

Objective: To compare the efficacy of postoperative patient-controlled analgesia (PCA) for different kinds of operations. Methods: 2256 patients were divided into ten groups according to the operation site. Score of the operation in analgesics (VAS) and side effects were observed. Results: VAS was less than 3 in all groups. VAS in group lung and esophagus was significantly higher than other groups in the first postoperative day, and VAS in group head and neck was higher than other groups in the second postoperative day. The PCA pressing times in the group upper abdomen were the most in all the groups. The satisfactory rate in the group heart was the lowest in all the groups. The incidence of nausea and vomiting was highest in the group breast, and the incidence of blood pressure change and respiration depression was highest in group lung and esophagus. Conclusions: Postoperative patient-controlled epidural or intravenous analgesia could provide effective analgesia. The dose of analgesics should be increased in major operations. The anti-vomiting drugs could prevent and decrease the incidence of nausea and vomiting.