硬膜外持续镇痛与静脉持续镇痛用于食道癌术后镇痛的比较

目的：探讨硬膜外持续镇痛与静脉持续镇痛方法用于食道癌三切口手术的镇痛效果、安全性及其副作用。方法：60例ASAⅠ～Ⅱ级行食道癌三切口手术的患者随机分为硬膜外持续镇痛组（CEA）和静脉持续镇痛组（CIA）。记录术后4、12、24、36、48小时两组患者的镇痛评分、副作用及术后追加药物的情况，持续监测患者的血压、心率、血氧饱和度、呼吸频率。结果：术后两组的患者的静息时的镇痛效果相近，但咳嗽时的镇痛效果CEA组优于CIA组（p〈0．05），副作用组间比较无差异（P〉0．05）。结论：对于食道癌三切口手术，硬膜外持续镇痛的镇痛效果优于静脉持续镇痛。

Compared Postoperative Continuous Epidural Analgesia to Continuous Intravenous Analgesia in Patients Undergoing Three-incision Surgery for Esophageal Cancer

Objective To assess the analgesic effect,safety and side effects of postoperative continuous epidural analgesia compared to continuous intravenous analgesia in patients undergoing three-incision surgery for esophageal cancer.Methods 60 patients undergo-ing three-incision surgery for esophageal cancer were randomly divided into two groups:group CEA were received postoperative contin-uous epidural analgesia,and group CIA received postoperative continuous intravenous analgesia.The pain distribution,side effects,and additional drugs to treat pain at postoperative several time points(4h,12h,24h,36h,and 48h)were recorded.Blood pressure,heart rate,oxygen saturation,respiratory rate were also monitored continuously in the 48h.Results There were no significant difference between two groups in analgesic effects when patients in resting(p>0.05),but the analgesic effect in group CEA is better than in group CIA when patients in coughing(p<0.05).Conclusions The study suggests that continuous epidural analgesia provide a better treatment to postoper-ative pain than continuous intravenous analgesia.