自控镇痛泵在手外伤术后患者中的应用

目的探讨自控镇痛泵在手外伤术后患者中的应用效果。方法按入院先后将2010年10月至2011年10月解放军第401医院收治的80例急诊手外伤患者分为观察组和对照组各40例,对照组术后镇痛采用盐酸哌替啶50mg,1次/6h肌内注射;观察组镇痛采用静脉自控镇痛泵,舒芬太尼0.1mg+盐酸奈福泮200mg+昂丹司琼16mg加入100ml生理盐水中,术后持续镇痛48h。记录并比较两组患者术后4、8、12、24和48h的视觉模拟疼痛评分(visual analogue scale/score,VAS)、镇静评分及不良反应发生率。结果术后4、8、12、24、48h观察组VAS评分均明显低于对照组(P<0.01),镇静评分除术后48h外均高于对照组(P<0.05或P<0.01);对照组患者的不良反应发生率明显高于观察组(P<0.05)。结论自控镇痛泵在手外伤术后患者中的应用,能提高术后患者的止痛疗效,减少不良反应的发生,效果确切,值得在临床推广应用。

Application of Patient-controlled Analgesia Pump for Postoperative Patients with Hand Surgery

Objective To explore the application effects of patient-controlled analgesia pump for patients after hand surgery. Methods Eighty patients （ASA Ⅰ - Ⅱ ） with acute hand injuries were divided into con-trol group （group B） and observational group （group A） ,with 40 cases in each group. Patients of group B using pethidine hydrochloride 50mg intramuscular injection every 6 hours after operation. Patients of group A used intravenous analgesia pump after surgery. The drugs in pump, including sufentanil 0.1 mg, nefopam hydrochloride 200mg and ondansetron 16rag, were diluted with normal saline into 100ml for 48h sustain- able intravenous injection. Scores of VAS 4h,8h, 12h and 24h after surgery,analgesic effect and complica-tions were recorded for both of the two groups. Results Scores of pain in group A 4h,8h,24h,48h after surgery were significantly lower than those in group B （P〈0.05 or P〈0.01） lSedation score of group B 4h,Sh,12h 24h after surgery was significantly lower than those of group A （P〈0.05）; The incidence of adverse reactions in group B was significantly higher than that in group A（P〈0.05）. Conclusion With ex-act effect, patient-controlled intravenous analgesia pump can improve the analgesic efficacy and decrease the adverse effect,which calls for further clinic application.