摘要
目的 :观察硬膜外术后病人自控镇痛 (PCEA)的镇痛效果、满意度、PCEA在全年麻醉总数中的比例 ,及文化程度、认知程度与PCEA应用比例的关系。方法 :回顾四年间PCEA实施情况 ,硬膜外穿刺点自T2 ～L3不等 ,手术结束按“负荷量 5ml+持续剂量 2ml/h +PCA 2ml”模式给药 ,PCA锁定时间为 30min。配方用吗啡 4mg或芬太尼 0 .8mg +氟哌利多 5mg + 0 .5 %布比卡因 2 5ml加生理盐水至 10 0ml。结果 :四年间麻醉总人数无明显增加 (P >0 .0 5 ) ,而PCEA逐年增加 ,差异显著 (P<0 .0 5 )。 2 0 0 0年产科PCEA已达 6 5 .34% ,外科PCA绝对数虽很低 ,但增长比例非常显著 (P <0 .0 5 )。应用PCEA的病例与学历有密切关系 ,大专、中专、初中三者比例分别为 5 5 .71%、2 6 .0 0 %、18.30 % ,有显著的统计学差异。认知程度、优良率与学历有关 ,尤其是初中以下者认知能力差 ,与大、中专比较差异非常显著 (P <0 .0 5 )。满意度为 81.5 7% ,三者比较无明显差异 (P >0 .0 5 )。结论 :PCEA是一种较为理想的镇痛方法 ,优良率、满意度高 ,有逐年增长趋势 ,其应用率与患者学历及认知程度呈正比关系。
Objective: To observe the analgesic effects and satisfactory degrees in patients with postoperative patient control epidural analgesia (PCEA), and to study the connections between the patients' education, knowledge and the application of PCEA. Methods: the range of epidural puncture point of all the patients who received PCEA is at T 2～L 3. The model of PCEA is 'loading dose(5ml)+continuous dose(2ml/h)+PCA(2ml)', and the lock time is 30min. The drugs of PCEA is morphine 5mg or fentanyl 0.8mg+droperidol 5mg+0.5% bupivacaine + normal saline, the total volume of PCA is 100ml. Results: the total number of patients under anesthesia has no significant increase in the past four years ( P >0.05),but the number of PCEA has increased gradually every year ( P <0.05). The percentage of PCEA in obstetrics has arrived 65.34% in 2000. Although PCA in surgery is not popular, the proportion is increasing very significantly ( P <0.05). The percentage of the high,middle or low education that received PCEA are different (55.71%,26.00% and 18.30%). The satisfactory degree is 81.57% and no significant change was found between different education levels ( P >0.05). Conclusion: PCEA is an effective method of analgesic with high satisfaction and tends to increase gradually every year. Patients with higher education are more likely to accept PCEA.
出处
《中国疼痛医学杂志》
CAS
CSCD
2002年第3期145-148,共4页
Chinese Journal of Pain Medicine
