硬膜外持续镇痛与静脉持续镇痛用于开胸术后患者的镇痛效果观察

目的 探讨硬膜外持续镇痛与静脉持续镇痛方法用于开胸手术的镇痛效果和安全性.方法 选择60例ASA Ⅰ～Ⅱ级行开胸手术的患者随机分为硬膜外镇痛组(EA)和静脉镇痛组(IA).记录两组患者术后4 h、12 h的镇痛评分、术后使用镇痛药物的情况、监测动脉血气的pH、PCO:和SpO2情况.结果 应用硬膜外持续镇痛与静脉持续镇痛均可取得满息的镇痛效果,EA组患者安静与活动时的疼痛评分低于IA组(P＜0.05);术后动脉血气分析显示两组患者的pH、PCO2和SpO2差异无统计学意义.结论 对于开胸手术,应用硬膜外持续镇痛与静脉持续镇痛均可取得满意的镇痛效果.硬膜外持续镇痛效果优于静脉持续镇痛,两种不同镇痛方式对术后患者酸碱平衡,PCO2和SpO2的影响无明显差异.

Observation of analgesic effect of epidural and intravenous continuous analgesia on open-chest surgery patients

Objective To explore the analgesic effect and safety of epidural and intravenous continuous analgesia on open-chest surgery patients.Methods 60 cases received ASA I～Ⅲ open-chest surgery were randomly divided into epidural analgesia(EA)group and intravenous analgesia(IA)group.The 4 h,12 h and postoperative pain score,use of drugs,and the PCO2 SpO2 and PH from monitoring of arterial blood gas were recorded.Results The application of epidural analgesia and intravenous continuous analgesia both obtained satisfactory analgesic effect.The pain scores in EA patients were lower than those in IA group at activities or quiet(P<0.05).Postoperative arterial blood gas analysis showed that there were no significant in terns of PCO2 SpO2 and pH between groups.Conclusions The application of epidural analgesia and intravenous continuous analgesia Can both obtain satisfactory analgesic effect among the patients with open-chest surgery.The analgesic effect of epidural continuous analgesia is better than that of intravenous continuous analgesia.There were no significant in terms of PCO2 SpO2 and pH between groups.