不同镇痛方法用于乳腺癌手术病人术后镇痛的疗效观察

目的将病人自控静脉镇痛(PCIA)和自控硬膜外镇痛(PCEA)分别用于乳腺癌手术病人术后镇痛,观察镇痛效果及不良反应情况。方法 60例ASAI～II级择期行乳腺癌手术病人,随机分为A组和B组,每组30例。A组在全麻诱导气管插管后及手术结束时各静注氟比洛芬酯50mg,并联合芬太尼开始PCIA,B组术后采用吗啡行PCEA,记录两组病人术后4、8、12、24、48h疼痛视觉模拟评分(VAS)及不良反应情况。结果两组病人术后各时点VAS差异无统计学意义;A组病人术后恶心呕吐、皮肤瘙痒、尿潴留等不良反应的发生率明显低于B组(P<0.05)。结论氟比洛芬酯术前超前镇痛并联合芬太尼行PCIA可以产生理想的镇痛效果,同时减少阿片类药物不良反应。

Comparison of Intravenous Flurbiprofen Axetil with Epidural Morphine and Ropivacaine in Patient-Controlled Analgesia after Breast Cancer Surgery

Objective To compare the efficacy and adverse reaction of intravenous flubiprofen axetil with epidural morphine and ropivacaine in patient-controlled analgesia after breast cancer surgery. Methods Sixty patients,ASA status I ～ II,undergoing breast cancer surgery were randomly divided into two groups. Patients in group A (n=30) were performed general anesthesia,received flurbiprofen axetil 50 mg injection after tracheal intubation and at the time when operation finished,then treated with patient-controlled intravenous analgesia with flurbiprofen axetil and fentanyl. In group B (n=30),patients were performed epidural anesthesia following with patient controlled epidural analgesia with morphine and ropivacaine. Results There were no differences between the two groups in postoperative pain scores. But the adverse effects such as PONV,pruritus,urine retention occurred more frequently in group A than group B (p <0.05). Conclusion Patientcontrolled analgesia with intravenous flurbiprofen axetil can be effectively used in breast cancer surgery to relief postoperative pain,which has less side effects than epidural morphine.