术后芬太尼皮下镇痛及对胃肠功能影响的研究

目的 比较术后芬太尼皮下镇痛(PCSA)与硬膜外镇痛(PCEA)的临床效果,以及对胃肠功能的影响.方法 2009年1-6月间观察择期硬膜外麻醉下经腹子宫切除术患者120例,术后分别实施PCSA与PCEA,观察术后第4、8、12、24、48 h的镇痛、镇静情况,呼吸循环、恶心呕吐及其他不良事件,记录术后首次肛门排气时间,...

Efficiency and Gastrointestinal Reaction of Subcutaneous Fentanyl Analgesic in Postoperative Patients

Objective To compare clinical efficiency and gastrointestinal reaction of subcutaneous patient-controlled analgesia（PCSA） and epidural patient-controlled analgesia（PCEA） with fentanyl analgesic for patients after operation.Methods A total of 120 patients having undergone transabdominal hysterectomy under epidural anesthesia between January and June 2009 accepted PCSA or PCEA after operation.We evaluated the state of analgesia and sedation at the 4th,8th,12th,24th and 48th hour after operation.We also looked into the respiration,blood circulation,nausea,vomiting and other abnormal events of the patients during the first 48 hours after operation.At the same time,we recorded the first time of anal exsufflation after operation and the degree of patients’ satisfaction.Results The analgesic effective rate was higher than 90% in both groups.There were no significant differences in analgesia and sedation scores at above-mentioned points after operation,incidence of nausea and vomiting,first time of anal exsufflation or analgesic effective rate between the two groups.Conclusion PCSA with fentanyl can be as effective in relieving postoperative pain as PCEA with fentanyl without obvious adverse effect in the gastrointestinal function.Therefore,PCSA is a safe and effective method to alleviate postoperative pain.