硬膜外负荷小量吗啡在前列腺摘除术后PCEA中的平衡应用

目的 观察硬膜外负荷小量吗啡在前列腺摘除术后硬膜外自控镇痛(PCEA)的平衡应用效果. 方法 选择前列腺摘除术后PCEA患者60例,随机分为A、B两组,每组30例,A组在术毕前30min经硬膜外导管注人负荷量小剂量吗啡1mg加1%利多卡因4ml,B组注人1%利多卡因4ml,之后两组均用芬太尼加局麻药行PCEA.观察两组患者术后2、4、8、12、24、48h的镇痛效果、膀胱痉挛发生情况、不良反应、术后患者肠蠕动恢复时间及患者自控给药量及总给药量.结果 A、B两组患者镇痛效果、不良反应、肠蠕动恢复时间比较差异无统计学意义(P＞0.05),A、B两组膀胱痉挛的发生和患者自控给药量及总给药量比较差异有明显统计学意义(P＜0.05). 结论 硬膜外负荷小量吗啡在前列腺摘除术后PCEA中可明显减少膀胱痉挛的发生率,自控给药量及总给药量,起到了平衡镇痛的作用.

Balance application of small amount epidural morphine in PCEA after prostatectomy

Objective To observe the balance application effects of small amount epidural morphine in PCEA after prostatectomy.Methods Sixty patients needing PCEA after prostatectomy were divided randomly into two groups,thirty cases in each group.Group A were given small amount morphine 1mg added 1% lidocaine 4ml through epidural catheter when the operation would be completed in 30min,and group B were treated with 1% lidocaine 4ml only in the same way,then both groups were given PCEA with local anesthesia added fentanly.The analgesia effects in 2h,4h,8h,12h,24h and 48h points after prostatectomy, cystospasm incidence and side effects were observed,and enterokinesia recovery time,patients self-controlled dosage and total dosage were recorded as well.Results Between group A and group B,there were no obviously statistical differences in analgesia effects,side effects and enterokinesia recovery time(P>0.05),but there was statistical significance in cystospasm incidence,patients self-controlled dosage and total dosage(P<0.05).Conclusion Small amount epidural morphine in PCEA after prostatectomy plays an excellent role in the balance analgesia,in addition,the cystospasm incidence,patients self-controlled dosage and total dosage are reduced markedly.