硬膜外腔连续镇痛用于肿瘤术后病人的临床观察

目的　观察硬膜外腔连续镇痛用于肿瘤术后病人的可行性。方法　 6 0例在硬膜外麻醉下行肿瘤切除术的患者随机分为硬膜外匀速输入组 (CCEA) ,即 4 8h内持续匀速注 0 12 5 %布比卡因 5ml/h和曲马多 12～ 2 0mg/h组和单次硬膜外注入组 (EPI)组 ,即手术结束时单次注入硬膜外腔吗啡 2mg。观察术后 4 8h内 2组呼吸、循环、镇痛、镇静评分及副作用。结果　术后 0～ 12h内CCEA组与EPI组镇痛效果相似 (P >0 0 5 )。镇静程度CCEA组高于EPI组 (P <0 0 5 )。 12h后CCEA组镇痛效果优于EPI组 (P <0 0 5 )。皮肤瘙痒EPI组 5例。结论　硬膜外腔连续镇痛效果确切 ,持续时间长、副作用少 ,可安全应用于肿瘤术后病人。

Clinical Observation of Continuous Epidural Analgesia in Patients after Tumor Operation

Objective To observe the feasibility of continuous epidural analgesia in patients after tumor operation. Methods 60 patients underwent tumor ectomy under epidural anesthesia were divided randomly into 2 groups. CCEA group: 0.125% bupivacaine(5ml/h) and tramal(12～20ml/h) epidurally administered continuously; EPI group: 2 mg morphine injected into epidural space after operation. Respiration, circulation, analgesia and sedation scores were recored over 2 days after operation. Results 0～12 hours after operation, analgesia effect in CCEA group was similar to that of EPI group (P>0.05); the degree of sedation in CCEA group was superior to that of EPI group (P<0.05).After 12 hours following operation, analgesia effect in CCEA group was superior to that of EPI group (P<0.05). Itch of skin occurs in 5 patients in EPI group. Conclusion The effects of continuous epidural analgesia are positive, and can last for a long time. There were few side effects. It can be safely applied to patients after tumor operation.