两种镇痛法对剖宫产病人术后留置导尿管舒适度的比较.doc

两种镇痛方法对剖宫产病人术后留置导尿管舒适度的比较 朱爱兵 徐志勇 【摘要】 目的 探讨剖宫产手术后病人自控静脉镇痛( PCIA) 和自控硬膜外镇痛( PCEA) 两种给药途径对术后留置导尿管舒适度的影响。方法 选择ASAⅠ～Ⅱ级硬膜外麻醉剖宫产术后自愿使用自控镇痛泵并留置导尿管的产妇120例，随机均分为三组：第I组患者为罗哌卡因复合吗啡硬膜外镇痛组；第II组患者为布托啡诺复合芬太尼静脉镇痛组；第III为对照组，患者术后根据临床需要，临时给予哌替啶50mg肌肉注射。分别记录评定三组产妇术后4、12、24和48h的镇痛效果和尿管留置期间舒适度。观察术后24小时恶心呕吐、皮肤搔痒和呼吸抑制的发生率。结果 I、II两组术后各时点镇痛效果和尿管留置期间舒适度优于对照组，差异有显著性(P0.05), I、II两组之间相比没有明显差异。术后24小时恶心呕吐、皮肤瘙痒和呼吸抑制的发生率三组之间没有明显差异。结论 剖宫产病人术后两种镇痛方法都可有效抑制导尿管带来的疼痛和不适。 【关键词】 剖宫产手术；自控镇痛；留置导尿；舒适度 Comparative study of two postoperative analgesic techniques on the comfort of retaining catheter after cesarean deliver ZHU Ai-bing,XU Zhi-yong.Department of Anesthesiology,Wuxi Maternal and Children’s Health Hospital.Wuxi 212001,China 【Abstract】 Objective To compare the efect of different postoperative analgesic techniques（PCEA and PCIA） on the comfort of retaining catheter after cesarean deliver. Methods 120 patients, ASA classⅠorⅡ, scheduled for cesarean deliver surgery received epidural anesthesia and retaining urethral catheterization after surgery and performing postoperative patient-controlled analgesia , were randomly divided equally into three groups: group I received ropivacaine + morphine for PCEA, group II received butorphanol + fentanyl for PCIA，group III(control group) received 50 mg pethidine when needed．The analgesic effect and the comfort of retaining catheter were observed at four time points:at 4，12，24 and 48 h after the end of surgery．The incidence of nausea and vomiting , skin titillation and respiratory depression after surgery were recorded . Results Compared with the control group, There were more excellent analgesic effect and the comfort of retaining catheter in group I and group II at all times after surgery (P0.05),while there were no significant differences between group I and group II (P0.05). Three groups hadn’t significant differences about the incidence of nausea and vomiting , skin titillation and respiratory depression (P0.05). Conclusion PCIA was as effective as PC