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臂丛神经阻滞联合患者自控镇痛用于前臂术后镇痛及恢复的临床疗效

Clinical efficacy of brachial plexus block with patient-controlled analgesia for postoperative analgesia and recovery in the antebrachium.

作者信息

Deng Rong-jian, Xu Jian-she, Wei Rong, Qin Zai-sheng

机构信息

Department of Anesthesiology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.

出版信息

Di Yi Jun Yi Da Xue Xue Bao. 2003 Apr;23(4):377-9.

Abstract

OBJECTIVE

To evaluate the analgesic effect of brachial plexus block using patient-controlled analgesia device after micro-surgery in the antebrachium and its impact on postoperative recovery.

METHOD

Twenty-four patients (ASA class I or II ) scheduled for micro-surgery in the antebrachium under brachial plexus block were randomly divided into PCBPA group (n=12) with patient-controlled analgesia and control group (n=12) without postoperative analgesia. In PCBPA group, postoperative patient-controlled analgesia was implemented using the mixture of 1% lidocaine and 0.25% bupivacaine and a computer- based system (Graseby 9300) with basal infusion of 2 ml/h, bolus dose of 3 ml and lockout time of 45 min. Visual analogue scale (VAS) was adopted for the evaluation of the pain intensity in both groups within 72 h after surgery, and changes in the mean arterial pressure (MAP) and heart rate (HR) observed during the peri-operation period.

RESULTS AND CONCLUSION

VAS, MAP and HR in PCBPA group were significantly lower than those in the control group ( P<0.05) within 24 h after surgery, suggesting the effectiveness of the analgesic modality using patient-controlled analgesia, which also inhibits postoperative stress reaction and promotes recovery following micro-surgery of the antebrachium.

摘要

目的

评估在前臂显微外科手术后使用患者自控镇痛装置进行臂丛神经阻滞的镇痛效果及其对术后恢复的影响。

方法

将24例计划在臂丛神经阻滞下进行前臂显微外科手术的患者(ASA分级I或II级)随机分为患者自控镇痛的PCPA组(n = 12)和无术后镇痛的对照组(n = 12)。在PCPA组中,使用1%利多卡因和0.25%布比卡因的混合液以及基于计算机的系统(Graseby 9300)实施术后患者自控镇痛,基础输注速率为2 ml/h,单次给药剂量为3 ml,锁定时间为45分钟。采用视觉模拟评分法(VAS)评估两组患者术后72小时内的疼痛强度,并观察围手术期平均动脉压(MAP)和心率(HR)的变化。

结果与结论

术后24小时内,PCPA组的VAS、MAP和HR显著低于对照组(P < 0.05),提示患者自控镇痛这种镇痛方式有效,且能抑制术后应激反应,促进前臂显微外科手术后的恢复。

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