自控硬膜外镇痛对术后胃肠功能的影响

目的 观察术后病人应用自控硬膜外镇痛（PCEA）的镇痛效应及其对胃肠功能的影响。方法 将240例腹部手术病人随机分为5组,Ⅰ~Ⅲ组病人术后应用不同药物配方和剂量的PCEA,Ⅳ、Ⅴ组病人术后无镇痛,记录其术后24 h视觉模拟评分（Visual analogue scale,VAS）及首次肛门排气时间。结果 对于上腹部手术,术后 PCEA联合用吗啡和布比卡因效果较好;对于下腹部手术,术后单用布比卡因PCEA即可。全部病人术后首次肛门排气时间无显著延长。结论 对于60岁以下的病人,术后适量吗啡、布比卡因PCEA效果好,不延长术后胃肠功能恢复的时间。

Effects of patient controlled epidural analgesia on gastrointestinal function recovery after operation

Objective To study the effects of patient-controlled epidural analgesia (PCEA) with morphine and bupivacaine on gastrointestinal function recovery after operation. Methods Two-hundred and forty patients undergoing elective abdominal surgery were divided into 5 groups, and patients in groupsⅠto Ⅲ received PCEA with bupivacaine and morphine postoperatively, while patients in groups Ⅳ and Ⅴ received no analgesia after operation. The Visual Analogue Scale (VAS) 24 h after the operation was adopted and the time of first flatus noted. Results For upper abdominal surgery, the effects of PCEA with bupivacaine combined with morphine were better than that with bupivacaine alone, while for lower abdominal surgery, bupivacaine alone was enough. PCEA with bupivacaine and morphine did not delay the time of first flatus after surgery. Conclusion PCEA with bupivacaine and morphine do not delay the time for gastrointestinal function recovery in patients.