美兰注射联合CIA用于肛肠病患者术后镇痛效果观察研究.docVIP

美蓝注射联合PCIA用于肛肠病患者术后镇痛效果观察研究 马月丽1，郭文义2 （山西职工医学院附属医院手术麻醉科 太原030012） 【摘要】　目的:研究肛肠疾病患者术后美蓝注射联合静脉自控镇痛( PCIA) 的效果和不良反应。方法:选择肛肠病患者手术90例(ASA Ⅰ～ Ⅱ) ,随机分为2组(A 组、B 组) ,每组30 例。其中,A 组为联合镇痛组，手术结束时局部美蓝注射+PCIA ;B为单纯PCIA组。采用视觉模拟评分（VAS）和患者舒适状态评分（BCS）观察记录两组术后4h、8h、24h、48h、60h疼痛强度和舒适状态，观察60h内不良反应的发生率。结果: 术后4h、8h、24h、48h两组患者VAS评分比较无显著性统计学意义（P＞0.05），但是术后60h镇痛泵撤除后两组患者VAS评分A组低于B组（P0.05）；术后4h、8h、24h、48h两组患者BCS评分比较无显著性统计学意义（P＞0.05），但是术后60h两组患者BCS评分A组高于B组（P0.05）；两组患者术后恶心呕吐、尿潴留、上消化道出血发生率比较无显著性统计学意义（P＞0.05），但B组头晕发生率较A组高（P0.05）。结论:美兰注射联合PCIA的镇痛模式用于肛肠手术患者在保证镇痛效果的同时，降低了不良反应发生率，延长了镇痛时间，更为有效的减轻患者的痛苦，患者更为舒适。 【关键词】　美蓝；舒芬太尼；酮咯酸氨丁三醇；静脉自控镇痛（PCIA） 【中图分类号】R614 【文献标识码】 【文章编号】 Observation and Research on postoperative analgesic effect of combined injection of Methylene blue and PCIA for anorectal patients. MA yue-li, GUO wen-yi. Department Anesthesiology , The ShanXi Medical University.The . Taiyuan 030012,China 【Abstract】Objective To study the analgesic effect and adverse reaction of combined administration of Methylthioninium Chloride and PCIA for postoperative anorectal patients. Methods 90 postoperative anorectal patients (ASA Ⅰ ~ Ⅱ) were randomly divided into 2 groups (group A,B), 30 cases in each group. Patients in group A were given combined injection of Methylthioninium Chloride and PCIA after operation. Group B were simply treated with PCIA. Using the visual analogue scale (VAS) to observe the pain intensity and incidence of adverse reactions in the two groups respectively 4h, 8h, 24h, 48h, 60h after operation. Result Results assessed by VAS in both groups 4h, 8h, 24h, 48h after operation showed no significant statistical difference (P 0.05), however, group A were lower than group B（P0.05）60h after operation when the analgesic pumps were removed. Results evaluated by BCS in both groups 4h, 8h, 24h, 48h after operation showed no significant statistical difference, but group A were higher than group B（P0.05）60h after operation. Higher incidence of dizziness in group B compared with group A (P 0