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目的:总结肿瘤患者术后静脉自控镇痛(patient-controlledinfusionanalgesiaPCIA)的效果。方法:600例ASA(美国麻醉医师协会分级法)Ⅰ～Ⅱ级术后患者,随机分为3组,每组200例。Ⅰ组为吗啡PCIA组,Ⅱ组为芬太尼持续背景静脉输注(continousbackgroundinfusionofnarcoticsCBI)组,Ⅲ组为芬太尼持续背景静脉输注的基础上,患者可自控输注小剂量芬太尼(5μg)组。观察3组患者术后4小时、8小时、12小时、24小时、48小时和72小时呼吸、循环、镇痛、镇静评分及不良反应。结果:3组镇痛方法的总满意度优良率均为90%以上,相比无显著性差异(P>0.05),但从镇痛、镇静效果比较,第Ⅲ组略优于Ⅰ、Ⅱ两组,而Ⅰ组患者呼吸抑制发生率低,安全性高,使用时间长。结论:术后静脉自控镇痛适用于手术创伤大、对疼痛耐受性差的患者。
Objective: To summarize the effect of postoperative patient-controlledinfusionanalgesiaPCIA in cancer patients. Methods: One hundred and sixty patients with ASA (American Society of Anesthesiologists grading) Ⅰ ~ Ⅱ were randomly divided into three groups (200 in each group). Group Ⅰ was morphine PCIA group, group Ⅱ was continuous intravenous infusion of fentanyl (continousbackgroundinfusionofnarcoticsCBI) group, group Ⅲ was continuous infusion of fentanyl intravenous basis, patients can be controlled infusion of small doses of fentanyl (5μg )group. Respiratory, circulatory, analgesic, sedation scores and adverse reactions were observed at 4h, 8h, 12h, 24h, 48h and 72h postoperatively in 3 groups. Results: The total satisfaction rate of three groups of analgesia was over 90%, there was no significant difference (P> 0.05), but from the analgesic and sedation effects, the third group was slightly better than Ⅰ and Ⅱ Group, while patients in group Ⅰ had a lower incidence of respiratory depression, higher safety and longer duration of use. Conclusion: Postoperative intravenous controlled analgesia is suitable for patients with large surgical trauma and poor pain tolerance.