摘要： 目的 比较静脉自控镇痛与硬膜外自控镇痛在经尿道膀胱肿瘤切除术 （TURBT） 后的镇痛效果。方法 选取2020年1月至2022年6月于我院泌尿外科行TURBT的60例患者为研究对象，术后30例患者接受静脉自控镇痛，30例患者接受硬膜外自控镇痛。比较2组患者在术后4 h （T1）、12 h （T2）、24 h （T3）、48 h （T4） 时间点的静息状态下视觉模拟评分法 （R-VAS） 疼痛评分、运动状态下视觉模拟评分法 （M-VAS） 疼痛评分、Ramsay镇静评分，以及术后镇痛指标 （术后镇痛药物追加次数、按压镇痛泵次数和有效按压次数）、术后康复指标 （首次排气时间、首次下床时间和住院满意度）、并发症发生率 （恶心呕吐、呼吸抑制、皮肤瘙痒、膀胱刺激征、心动过缓） 的差异。结果 2组患者术后T1~T4时间点R-VAS疼痛评分和M-VAS疼痛评分均逐渐下降 （P< 0.05）； 各时间点2组比较，R-VAS疼痛评分、M-VAS疼痛评分、Ramsay镇静评分均无统计学差异 （P> 0.05）。2组比较，术后镇痛指标、术后康复指标和并发症发生率均未见统计学差异 （P> 0.05）。结论 静脉自控镇痛与硬膜外自控镇痛在TURBT后均有良好的镇痛效果，2种镇痛方式在术后镇痛效果以及并发症方面无显著差异。

静脉自控镇痛与硬膜外自控镇痛在经尿道膀胱肿瘤切除术后镇痛效果的比较

孙凡皓, 于红, 殷波

中国医科大学附属盛京医院泌尿外科, 沈阳 110004

收稿日期:2022-11-21出版日期:2023-05-30发布日期:2023-05-26
通讯作者:孙凡皓E-mail:sfh1244887691@163.com
作者简介:孙凡皓 (1994-),女,护师,本科.
基金资助:辽宁省民生科技计划联合计划(2021JH2/10300099)


关键词: 静脉自控镇痛, 硬膜外自控镇痛, 经尿道膀胱肿瘤切除术
Abstract: Objective To compare the effect of patient-controlled intravenous and epidural analgesia after transurethral resection of bladder tumor (TURBT). Methods In this study,60 patients who underwent TURBT at the Department of Urology,Shengjing Hospital between January 2020 and June 2022 were selected,including 30 who received postoperative patient-controlled intravenous analgesia and 30 who received postoperative patient-controlled epidural analgesia. The visual analogue scale at rest (R-VAS),visual analogue scale during movement (M-VAS),and Ramsay sedation scores 4 (T1),12 (T2),24 (T3),and 48 h (T4) after surgery were compared between groups. The postoperative analgesic indexes (including numbers of additional postoperative analgesic drugs,pressed analgesic pumps,and effective presses),postoperative recovery indexes (including time to first ventilation,time to first bed release,and hospital satisfaction),and incidence of complications (including nausea and vomiting,respiratory depression,skin pruritus,bladder irritation signs,and brady-cardia) were compared between groups. Results The R-VAS and M-VAS scores decreased gradually from T1 to T4 in both groups (P< 0.05). No significant intergroup differences in R-VAS,M-VAS,and Ramsay sedation scores were found at each time point (P> 0.05). No significant intergroup difference was noted in the analgesic indexes and incidence of complications (P> 0.05). Conclusion Both patient-controlled intravenous and epidural analgesias have good analgesic effects after TURBT without significant differences in postoperative analgesic effects or complication rates.
Key words: patient-controlled intravenous analgesia, patient-controlled epidural analgesia, transurethral resection of bladder tumor
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