丙帕他莫复合吗啡自控静脉镇痛用于开腹结肠癌根治术后的镇痛效果

目的观察丙帕他莫复合吗啡自控静脉镇痛（PCIA）用于开腹结肠癌根治术患者术后镇痛的效果及安全性。方法 80例ASAⅠ或Ⅱ级行结肠癌根治术患者随机分为两组,吗啡组（M组）和丙帕他莫复合吗啡组（P组）。术毕均给与静脉自控镇痛（PCIA）,镇痛药物吗啡1mg/mL,镇痛方案：负荷量1mL,维持量0.5mL/h,追加量1mL,锁定时间5min。P组手术结束前30min、之后12、24、36h分别静脉滴注丙帕他莫2g,M组相同时间点给予等容量生理盐水。两组均镇痛至术后48h。记录术后12、24、36和48h安静和咳嗽VAS评分,镇静Ramsay评分及镇痛期间不良反应发生率,记录PCA总按压次数、有效按压次数及吗啡用量。结果两组患者各时点VAS评分无差异。与M组比较,P组Ramsay评分、PCA总按压次数、有效按压次数、吗啡用量、不良反应发生率降低（P〈0.05）。结论丙帕他莫复合吗啡自控静脉镇痛用于开腹结肠癌根治术患者术后镇痛的效果较好,不良反应发生率低。

Effect of propacetamol combined with morphine for patient-controlled intravenous analgesia after abdominal radical operation for the carcinoma of colon

Objective To observe the analgesic efficacy and safety of propacetamol combined with morphine for patient-controlled intravenous analgesia（PCIA）after radical operation for the carcinoma of colon.Methods Eighty ASA Ⅰ orⅡ patients undergoing abdominal radical operation for the carcinoma of colon were randomized into two groups：the morphine group（group M）and propacetamol plus morphine group（group P）.All the patients were given PCIA for 48 hafter the operation.1mg/mL morphine was administrated as the analgesic drugs,and the analgesic parameter was as follows：loading dose 1mL,infusion rate 0.5mL/h,bolus dose 0.5mL,lockout time5 min.Patients in group P were treated with 2g proacetamol at the following time point：30min before the end the operation,12 h,24h,36 hafter the first administration.Patients in group M were given the equal volume normal saline at the same time point.Visual analog score（VAS）of pain while quiet and coughs,Ramsay sedation score were measured at 12,24,36,48 hafter the operation.The number of unsatisfied demand and the successful deliver doses,the morphine consumption and the side effects were recorded.Results There were no significant different in the VAS score between the two groups.The Ramsay score,number of unsatisfied demand and successfully delivered doses,morphine consumption,the incidence of side effects in group P reduced,compared to group M（P〈0.05）.Conclusion Propacetamol combined with morphine produces effective analgesia in patient after abdominal radical operation for the carcinoma of colon,with less side effects.