摘要
目的 观察泼尼松龙硬膜外给药对脊柱手术术后疼痛的影响。方法 42例ASAⅠ～Ⅱ级 ,年龄 43～ 6 5岁 ,体重 45～ 92kg的择期脊柱手术的患者随机分为实验组 (E组 )和对照组 (C组 ) ,每组 2 1例。采用连续硬膜外麻醉 ,在手术结束前 0 .5h ,E组患者经硬膜外导管给予泼尼松龙溶液 10～ 15ml,C组患者则给予同等容量的生理盐水。分别在手术结束后 4h、8h、12h、2 4h、48h观察患者疼痛、镇静程度和恶心、呕吐、尿潴留、皮肤瘙痒等并发症的发生状况 ,同时观察各时刻患者的呼吸、循环功能。结果 E组患者术后各时刻的疼痛评分均低于 2分 ,无镇静 ,无恶心、呕吐、尿潴留、皮肤瘙痒等并发症发生。C组在各时刻的疼痛评分均明显高于E组 ,分别为 8.2 6±2 .34、6 .5 7± 1.6 9、5 .48± 2 .2 5、5 .36± 1.14和 4.35± 1.18,而且每隔 8～ 12h需给患者静脉滴注镇痛药曲马多 ;患者在除术后 4h和 8h外的各时刻的镇静程度评分明显高于或有高于E组的趋势 ,恶心、呕吐的发生率也明显高于E组 ,但无皮肤瘙痒发生。结论 泼尼松龙硬膜外给药能明显控制脊柱手术患者的术后疼痛 ,且无恶心、呕吐、尿潴留、皮肤瘙痒等并发症发生。
Objective To observe the effects of extradural prednisone injected for postoperative analgesia in spinal column surgery.?Methods 42 patients (ASA scale Ⅰ～Ⅱ)undergoing spinal column surgery were randomly assigned to group E(experimental) and group C(control). Group E were given prednisone in 10～15 ml bolus via the extradural catheter 30 min before the end of operation; group C were injected equal volume of 0.9% saline solution. The patients were followed up at 4,8,12,24 h after operation, and the degrees of pain, sedation and postoperative nausea and vomiting(PONV),the heart rate, blood pressure and respiratory frequency ,and the consumption of analgesic were recorded.?Results Not only the pain score and PONV score in group E significantly lower than that in group C during the whole course of follow-up, but also the degree of sedation were less than that in group C at 12,24,48 h after operation.?Conclusion Extradural administration of prednisone can significantly relieve pain after spinal column surgery, and has less side effects.
出处
《徐州医学院学报》
CAS
2000年第3期178-180,共3页
Acta Academiae Medicinae Xuzhou
关键词
泼尼松龙
脊柱手术
手术后镇痛
硬膜外给药
prednisone
extradural
spinal column surgery
postoperative analgesia
