耳穴压豆联合硬膜外麻醉镇痛用于剖宫产术后镇痛的疗效研究

目的：观察耳穴压豆联合硬膜外麻醉镇痛对剖宫产术后镇痛的影响。方法选择2012年12月-2013年12月就诊于我院并行剖宫产术的患者400例，随机分为观察组和对照组，每组各200例。对照组采用镇痛泵与硬膜外导管连接，泵内药物由芬太尼0.3 mg＋盐酸罗哌卡因150 mg＋生理盐水100 mL组成，以2 mL/h匀速泵入硬膜外间隙，术后48 h拔出导管；观察组于术毕另予耳穴压豆疗法，观察两组患者术后8 h、12 h、24 h、36 h及48 h的疼痛VAS、PRI及PPI评分及不良反应。结果观察组术后VAS、PRI及PPI评分明显低于对照组，差异有统计学意义（P〈0.05）；观察组术后镇痛不良反应率（9.5%）明显低于对照组（22.5%），差异有统计学意义（P〈0.05）。结论耳穴压豆联合硬膜外麻醉镇痛能增强剖宫产术后镇痛作用，减少各种不良反应的发生，值得推广。

A study on curative effect of auricular point therapy combined with epidural anesthesia for postoperative analgesia of caesarean section

Objective To observe the effect of auricular point therapy combined with epidural anesthesia for postopera-tive analgesia of caesarean section. Methods A total of 400 patients who were admitted to our hospital and received caesarean section from December 2012 to December 2013 were selected. They were randomly allocated to an observa-tion group and a control group, with 200 patients in each. The control group received analgesia infusion pump connect-ed to an epidural catheter, and the drugs in the pump were comprised of 0.3 mg of fentanyl plus 150 mg of ropivacaine hydrochloride plus 100 mL of normal saline. The drugs were pumped into epidural space with a constant speed of 2 mL/h. The catheter was removed in 48 hours after the surgery; The observation group further received auricular point therapy. Scores of VAS, PRI and PPI in 8 hours, 12 hours, 24 hours and 36 hours after the surgery and related adverse events in the two groups were observed. Results Scores of VAS, PRI and PPI after the surgery in the observation group were all significantly lower than those in the control group, and the differences were statistically significant （P〈0.05）. The rate of adverse events after the analgesia in the observation group were 9.5%, significantly lower than that of 22.5% in the control group, and the difference was statistically significant （P〈0.05）. Conclusion Auricular point thera-py combined with epidural anesthesia helps strengthen the postoperative analgesia of caesarean section and reduce ad-verse events, which is worthy of promotion.