术后硬膜外自控镇痛与单次注药镇痛的效果对比观察

目的：比较术后硬膜外自控镇痛法与单次注药法的临床镇痛效果和安全性。方法：60例在硬膜外麻醉下行胆道手术的病人，随机分成两组，硬膜外自控镇痛组（PCEAn=30),硬膜外单次注药组（EPIn=30)。手术结束时，PCEA组硬膜外导管接自控镇痛泵（简称PCA），药液用0．006％吗啡加0．15％布比卡因，由病人自行给药镇痛。EPI组经硬膜外导管一次注入吗啡2mg。在术后4、8、12、24h进行随访并记录：（1）疼痛评分（用VAS法）；（2）平均动脉压（MAP）和呼吸频率（RR）；（3）副作用发生率如呼吸抑制、恶心、呕吐、尿潴留等。结果：在术后各时点的VAS评分两组差异无显著意义（P＞0．05），MAP及RR两组差异也无显著意义（P＞0．05），24h副作用发生率两组亦差异无显著意义（P＞0．05）。结论：PCEA和EPI两种方法都有良好的镇痛效果和安全性。

A comparison of observation of patient-controlled epidural analgesia with epidural-injected analge sia for post-operation pain

Objective To compare the effects and safety of patient-controlled epidural analgesia with epidural-injected analgesia for post-operative pain. Methods sixty patients undergoing cholecystectomy with epidural anesthesia were randomy assigned to two groups. At the end of operation, patient-controlled epidural groups (PCEA) were received epidural 0.006% morphine mixed with 0.15% bupivacaine infusion under the control of patient. Epidural-injected analgesia groups (EPI) with 2mg morphine were epidurally administered. At 4, 8, 12 and 24h following operation, pain score (VAS), mean arterial pressure (MAP) and respiration rate (RR), incidence of side effect were assessed. Results There is no significant difference between the two groups in pain score and MAP, RR and incidence of side effects. Conclusion Both PCEA and EPI were safe and effective methods for patient postoperative analgesia.