硬膜外自控镇痛用于剖宫产术后效果观察

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1、硬膜外自控镇痛用于剖宫产术后效果观察赵洁(山东省泰安市中心医院山东泰安271000)【中图分类号】R614.2【文献标识码】A【文章编号】1672-5085(2012)19-0097-02【摘要】目的观察硬膜外自控镇痛(PCEA)法用于剖宫产术后镇痛的效果。方法选取剖宫产术后患者252例，随机分成观察组和对照组，每组各126例。观察组患者应用含0.75%布比-卡因20ml、芬太尼0.3mg的自控镇痛泵，根据术后疼痛程度患者自控给药。对照组术后6h肌注杜冷丁100mg,采用视觉模拟评分法，分别观察2组患者术后的镇痛效果，肠蠕动恢复时间、拔管后排尿情况，产

2、后出血量，恶心呕吐情况，48小时内母乳喂养情况。结果①观察组患者术后无明显疼痛感，镇痛效果良好。而对照组患者则有明显的术后疼痛感。差异极显著(p<0.01)。②观察组患者术后肠蠕动恢复时间快，而对照组慢，差异显著(p<0.01)o③2组把尿管后排尿情况，恶心呕吐、产后岀血量均无显著性差异(p>0.05)o④48小时母乳喂养情况有显著性差异(p<0.01)o结论PCEA有良好的剖宫产术后镇痛效果，术后肠蠕动恢复快，母乳喂养率高。【关键词】剖宫产硬外膜镇痛Efficacyofpatient-controlledepiduralanalgesiaafterc

3、esareansection【Abstract】ObjectiveToobservetheefficacyofpatient?controlledepiduralanalgesia(PCEA)aftercesareansection.Methods:Inthisstudy,252womenundergoingelectivecesareansectionwereallocatedinto2groups(PCEAgroupandcontrolgroup)randomlyandequally.PCEAwasadministered,accordingtot

4、hepainseverityaftercesareansectionbythepatient・controledway,with0.75%bupivacaine20mlandfentanyl0.3mgintheobservinggroup.WhilecontrolgroupwasgivenintramuscularinjectionofdolendinlOOmgforanalgesiain6hafteroperation.Visualanaloguescalewasusedtoevaluatetheanalgesiceffect.Theeffectof

5、painalleviating,timeoftherecoveryofintestinalperistalsis,mictionconditionafterextubation,amountofpostpartumhemorrhage,theincideneeofnauseaandvomitingandtheinflueneetopostpartumbreastfeedingin48hwereobserved.Results:①Inobservinggroup,thepatientshadmuchlesspainthaninthecontrolgro

6、up,thediffereneewassignificant(p<0.01).②Timeoftherecoveryofintestinalperistalsisinobservinggroupquick,whileincontrolgroupslow0.Thediffereneewassignificant(p<0.01)・③Therewasnoremarkablediffereneebetweentwogroupsinmictionconditionafterextubationztheincidenceofnauseaandvomitinganda

7、mountofpostpartumhemorrhage(p>0.05).@Theinflueneetopostpartumbreastfeedingin48hhadsigrdficantdifference(p<0.01)・Conclusion:PCEAforpostoperativeanalgesiaofcesareansectionhasgoodanalgesiceffects,withquickerpost・operativeintestinalperistalsisrecoveryandhigherbreastfeedingrate.【Keyw

8、ords]cesareansectionepiduralanalgesia剖宫产术后疼痛严重影