硬膜外途径术后镇痛病人提前终止用药的原因分析

目的 探讨术后硬膜外镇痛病人提前终止用药的原因.方法 回顾近3年4876例采用硬膜外术后镇痛患者的资料,了解镇痛效果和提前终止用药的发生情况,并记录与分析病人提前终止用药的有关因素.结果 113例患者提前终止术后镇痛,发生率为2.32%.非并发症原因致提前终止镇痛有74例,占1.52%;578例患者出现镇痛并发症,因各种并发症而提前终止镇痛者仅为39例,占0.80%.结论 非并发症原因即医护人员操作性问题是引起提前终止用药的主要原因,加强技术培训和术后镇痛规范化管理是减少提前终止镇痛的主要对策.

Analysis of factors leading to prescheduled analgesic withdrawal in patients with postoperative epidural analgesia

Objective To analyze the factors leading to prescheduled analgesic withdrawal in patients with postoperative epidural analgesia.Methods A retrospective study of 4876 patients with postoperative epidural analgesia was conducted and the effect of analgesia and incidence of prescheduled analgesic withdrawal were recorded.The factors precipitating the occurrences of analgesic withdrawal and complications were analyzed.Results Early analgesic withdrawal occurred in 113 cases(2.3%),among which 74(0.5%) were due to factors irrelevant to analgesic complications.Analgesia-related complications occurred in 578 patients,but only 39(0.7%) of them needed discontinuation of the analgesics.Conclusion Prescheduled analgesic withdrawal is predominantly due to technical inadequacies rather than complications arising from the analgesics,and improvement of the operation skills for postoperative analgesia may reduce early analgesia discontinuation and enhance the patients' satisfaction.