开胸术后常用镇痛方法的对比分析

目的：评价医师控制镇痛（DCA）、病人自控硬膜外镇痛（PCEA）和病人自控静脉镇痛（PCIA）对开胸术后疼痛的治疗效果。方法：将开胸术后病人33例随机平均分入DCA组、PCEA组、PC认组。采用疼痛视觉模拟评分法评定上述三组病人的术后疼痛，并观察与镇痛有关的副作用。结果：开胸术后48h内平静状态时，DCA组病人的疼痛积分高于PCEA及PCIA组（P〈0．05）；术后24h时内咳嗽时，DCA组病人的疼痛积分高于PCEA组（P〈0．05）；术后24h后咳嗽时三组间病人的疼痛评分元显著差异（P〉0．05）；开胸术后任何时段PCEA与PC认两组间病人疼痛评分元显著差异（P〉0．05）。三组间与疼痛和镇痛有关的并发症发生率元显著性差异（P〉0．05）。结论：PCEA和PCIA对开胸术后早期疼痛有较理想的治疗效果。

COMPARATIVE ANALYSIS ON ANALGESIA FOR POST-THORACOTOMY PAIN

Objective:To assess the curative effectiveness of doctor-controlled analgesia(DCA)(pain relief according to their requisition),patient-controlled epidural analgesia(PCEA),and patient-controlled intravenous analgesia(PCIA) for post-thoracotomy pain.Methods: 33 post-thoracotomy patients were divided into DCA,PCEA and PCIA groups.By means of visual analogue scale,severity of post-thoracotomy pain and curative effectiveness of various modalities of analgesia were assessed.Results: Compared with the patients who received DCA,the patients receiving PCEA and PCIA experienced less pain within 48 hours after thoracotomy.When coughing 24 hours after thoracotomy,patients receiving DCA experienced more pain that those receiving PCEA and PCIA(P<0.05).There is no statistical difference of complication related to post-thoracotomy pain analgesia between three groups 24 hours after thoracotomy.Conclusion:Both PCEA and PCIA showed an ideal curative effectiveness for post-thoracotomy pain control.