不同镇痛方法用于肝癌患者术后镇痛效果的临床比较

目的比较硬膜外自控镇痛和静脉自控镇痛用于肝癌术后镇痛的临床效果。方法60例ASAⅠ-Ⅱ级肝癌患者分为两组，每组30例。Ⅰ组为静脉复合全麻，术后经静脉曲马多（12mg／kg）自控镇痛；Ⅱ组为静脉复合全麻联合胸部硬膜外阻滞，术后硬膜外吗啡5mg＋布比卡因100mg自控镇痛，用视觉模拟评分（VAS）判定术后镇痛效果。结果两组手术患者均有较好的术后镇痛效果，Ⅰ组患者的VAS评分于术后各时点分别明显高于相对应的Ⅱ组的VAS评分（P〈0．05）。结论硬膜外镇痛是肝癌患者术后较为合适的的镇痛方法。

Clinic comparsion of different analgesia methods in the patients with hepatic carcinoma undergoing surgery

Objective To compare the clinic effect of patient - controlled epidural analgesia and patient - controlled venous analgesia on the visual analog scale in the patients with hepatic carcinoma undergoing surgery. Methods Sixty hepatic carcinoma patients, classified as ASA physical status Ⅰ - Ⅱ, scheduled for elective abdominal surgery were enrolled. Sixty patients were randomly subdivided equally into two treatment groups： group I received general anesthesia（GA） during surgery and patient -controlled intravenous analgesia （PCIA） with tramadol （12 mg/kg）postoperatively; group Ⅱ underwent general anesthesia （GA） plus epidural anesthesia （PEA） during surgery and patient -controlled epidural analgesia （PCEA） with morphine and bupivacaine postoperatively. Results The analgesia effect was satisfactory in two groups , whereas the VAS values in group Ⅰ was higher than those in group Ⅱ on the postoperative 4, 24 and 48 hours （ P 〈 0.05）. Conclusion Patient - controlled epidural analgesia （PCEA） is a reasonable way for patients with hepatic carcinoma undergoing surgery.