【摘要】 目的　探讨耻骨上经膀胱前列腺切除术后不同镇痛方法的效果。方法　选择 75例施行耻骨上经膀胱前列腺切除术患者 ,随机分成PCIA组、CIEA组及对照组 ,每组 2 5例。PCIA组术后 48h静脉持续注入吗啡 ( 2 0mg/h) ,患者疼痛时自行追加吗啡1 0mg/次 ,锁定时间 2 0min ;CIEA组术后 48h持续经硬膜外导管注入吗啡 ( 0 0 8mg/h)。对照组出现疼痛时肌注哌替啶 5 0～ 75mg或其他解痉镇痛药。以镇痛治疗期间患者的视觉模拟评分 (VAS)、膀胱痉挛次数及持续时间、膀胱冲洗时间、血压等为指标进行观察比较。结果　CIEA组及PCIA组与对照组比较具有镇痛效果显著、膀胱痉挛次数少、疼痛持续时间短、膀胱冲洗时间短的优点 (P <0 0 1)。PCIA组与CIEA组比较上述指标差异无显著性 ( P >0 0 5 )。PCIA组与其他两组比较肛门排气时间延长 ( P <0 0 1)。结论　CIEA及PCIA对经膀胱前列腺摘除术后患者镇痛效果良好 ,以CIEA为优更多还原

【Abstract】 Objective To observe the analgesic effects of patient-controlled intravenous analgesia (PCIA) and continuous infusion of morphine into epidural space(CIEA) after suprapubic transvesical prostatectomy. Methods Seventy-five patients undergoing suprapubic transvesical prostatectomy were randomly assigned to PCIA group,CIEA group and control group. In PCIA group, 2 0mg/h morphine as a recommended dose would be injected intravenously by the patient through a self-controlled analgesic delivery system in which another 1 mg morphine could be injected whenever patient felt pain until the pain relieved. The lockout time was 20 minutes. In CIEA group, 0 08 mg/h morphine was injected into epidural space. 50～75mg of pethidine was injected whenever the control group patients felt pain. VAS(vision simulate score), frequency and duration of bladder spasm, discontinuance time of bladder irrigation and BP were observed. Results The CIEA and PCIA group were superior to the control group with characteristics of stable analgesic effect, shorter duration and lower frequency of bladder spasm and shorter time of bladder irrigation(P<0 01), while there was no significant difference in these items between the CIEA and PCIA groups (P>0 05); but the PCIA group had longer gastrointestinal function recovery time(P<0 01). Conclusion The analgesic effects of morphine PCIA and CIEA are very good for patients undergoing superpubic transvesical prostatectomy, conclusively, CIEA is better.更多还原