丁卡因联合用药对前列腺汽化电切术后镇痛观察护理.docVIP

丁卡因联合用药对前列腺汽化电切术后镇痛观察护理 　【摘要】 目的 观察丁卡因联合吗啡、氟哌啶用于前列腺汽化电切术后患者自控硬膜外镇痛（PCEA）护理效果。方法 将80例前列腺术后随机分为试验组与对照组各40例，试验组术毕保留硬膜外导管，接国产“驼人牌”一次性患者自控硬膜外镇痛泵，药液配方为丁卡因100 mg+吗啡10～15 mg+氟哌啶5 mg加入生理盐水至100 ml，LCP模式（负荷量：吗啡2～3 mg，背景量：2 ml/h，PCA 0.5 ml/次）；对照组据疼痛症状经硬膜导管推注吗啡3 mg/次解痉止痛，观察并记录术后解痉镇痛效果及不良反应。结果 试验组39例疗效显著，1例效果一般，不良反应及术后自觉症状明显低于对照组，两组比较用χ2检验关异有统计学意义（Plt;0.05）。结论 丁卡因加吗啡、氟哌啶用于前列腺汽化电切术后患者自控硬膜外镇痛安全、有效，且护理方便，可有效减轻患者痛苦，减少术后膀胱痉挛和出血量，缩短冲洗时间，有利于患者康复。 【关键词】 前列腺汽化电切术 自控硬膜外镇痛 丁卡因 护理 ［Abstract］ Objective To observe the effect of patient-controlled epidural analgesia（PCEA） with combination of dicaine, morphine and droperidol on the patients after electrovaporization of the prostate. Methods 80 cases were divided into control group and test group with 40 cases respectively. Epidural catheter was left in test group, connected with “Tuoren” patient-controlled epidural analgetic pump with dicaine 100 mg+morphine 10～15 mg+droperidol 5 mg,which were dissolved into NS to 100 ml. LCP model was as follows:morphine 2～3 mg, background dosage: 2 ml/h, PCA 0.5 ml each time; The control group injected morphine 3 mg through epidural conduit each time to relieve spasm and pain according to the symptoms to observe and record the effects and side effects. Results Test group:39 cases were with remarkable effect, 1 cases was common. Side effects and symptoms were significantly lower than the control group（P＜0.05） Conclusion Dicaine, morphine and droperidol on the patients after electrovaporization is a safe, effect, convenient method for patient-controlled epidural analgesia. It will effectively relieve pain, reduce postoperative bleeding and bladder spasm and shorten the washing time so as to help patients with rehabilitation. ［Key words］ electrovaporization of prostate; patient-controlled epidural analgesia; dicaine;nursing 前列腺汽化电切术后膀胱痉挛和继发出血是常见的并发症。近几年临床用布比卡因+吗啡+氟哌啶配方行PCEA，疗效不是很显著［1］。作为脂类局部麻药，丁卡因用于术后镇痛的报道甚少。我院改用丁卡因加吗啡、氟哌啶用于前列腺汽化电切术后硬膜外自控镇痛，收到满意疗效，现报告如下。 1 资料与方法 1.1 一般资料 随机选择80例前列腺汽化电切术手术患者，年龄58～85岁，平均71岁，A