前列腺切除术后患者自控硬膜外镇痛防治膀胱痉挛

为观察患者自控硬膜外镇痛技术（PCEA）在前列腺切除术后膀胱痉挛防治中的效果，将60例行耻骨上经膀胱前列腺切除术患者术后按不同的解痉镇痛方法随机分为两组。观察组30例给予吗啡4mg、布比卡因150mg，生理盐水稀释成150ml，通过保留的硬膜外导管采用美国Baxter公司PCA－Ⅱ型自控镇痛泵持续给药，2ml/h。对照组30例给予杜冷丁50mg、阿托品0.5mg肌肉注射。所有患者均治疗3天，以疼痛视觉模拟评分法（VAS）间接评估镇痛效果，纪录膀胱痉挛次数、持续时间。结果术后膀胱痉挛发生率观察组为18％、对照组为83％（P＜0．01）；术后72小时内膀胱痉挛发生次数和持续时间观察组＜对照组（P＜0．01）；术后镇痛效果观察组好于对照组（P＜0．01）。认为PCEA能明显降低前列腺切除术后膀胱痉挛的频度和强度，镇痛效果优于其它方法。

PCEA on bladder spasm after prostatectomy

To observe the effect of postoperative patient controlled epidural analgesia (PCEA) on bladder spasm after prostatectomy.60 patients scheduled for suprapubbic transvesical prostatectomy. They were randomly divided into PCEA group (n=30) and control group (n=30).After operation,PCEA was applied in PCEA group,pethidine and atropine were given intermittently in control group.All patients were treated 3 days after operation. Analgesia effect was indirect scored on the visual analog scale (VAS). Number of times and period of bladder spasm were recorded. Results showed that the incidence of bladder spasm after operation was 18% in PCEA group, and 83% in control group(P<0.01).Compared with control group,PCEA group had significantly lower VAS pain scores (P<0.01) and significantly higher postoperative analgesia effect (P<0.01). It suggests PCEA is believed to decrease the frequency and intensity of bladder spasm after prostatectomy.