【摘要】 目的观察吸烟者胸部手术后的自控静脉镇痛(PCIA)效果。方法采用回顾性分析方法,将152例实施PCIA的男性胸部手术患者分为非吸烟组(NS组)70例和吸烟组(S组)82例,比较两组术中芬太尼用量、手术时间及术后24、48 h的舒芬太尼用量;术后0~48 h采用数字评价量表(NRS)评估静息与咳嗽时的疼痛评分;观察有无镇痛相关不良反应。结果两组术中芬太尼用量、手术时间均无显著差异(P均>0.05);S组术后24、48 h舒芬太尼累积用量及每千克体质量用量均明显大于NS组,术后0~48 h静息与咳嗽时NRS评分均高于NS组(P均<0.05);两组术后恶心、呕吐、过度镇静、呼吸抑制发生率无显著差异(P均>0.05)。结论与不吸烟者比较,吸烟者胸部手术后疼痛程度增强、PCIA所用药物剂量增大,但PCIA相关不良反应无明显变化。更多还原

【Abstract】 Objective To investigate the effect of postoperative patient-controlled intravenous analgesia( PCIA) in smoking patients undergoing thoracic surgery. Methods The retrospective analysis method was used. Totally 152 male patients undergoing thoracic surgery and received postoperative PCIA were divided into the non-smoking group( group NS,n= 70) and smoking group( group S,n = 82). The dosage of sufentanil during surgery,operation time,cumulative amount of self-administered sufentanil at 24 and 48 h after surgery were compared between the two groups. The numerical rating scale( NRS) was used to assess the tranquillization and coughing pain intensity during 0-48 h after surgery. Analgesia related adverse reactions were observed. Results There were no significant differences in the dosage of sufentanil during surgery and operation time between groups NS and N( all P > 0. 05). The cumulative amount and dosage per body weight of sufentanil at 24 and 48 h in the group S were significantly higher than that in the group NS,and the NRS scores at tranquillization and coughing( 0-48 h after surgery) were significantly higher in the group S than those of the group NS( all P< 0. 05). No significant differences were found in the postoperative complications such as nausea and vomiting,sedation,and the incidence of respiratory depression between the two groups( all P > 0. 05). Conclusion Compared with nonsmokers,smokers have more severe postoperative pain and require a higher dosage of PCIA used medicine,but there are no significant differences in PCIA-related adverse reactions.更多还原