Clinical observation of multiple-mode analgesia on patients after thoracic surgeries
10.3760/cma.j.issn.1673-4904.2011.20.010
- VernacularTitle:胸科手术多模式镇痛的临床观察
- Author:
Lihua TANG
;
Yuxia JIAO
;
Dongbai LI
- Publication Type:Journal Article
- Keywords:
Analgesia;
Anesthesia,epidural;
Lidocaine;
Parecoxib
- From:
Chinese Journal of Postgraduates of Medicine
2011;34(20):27-30
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of multiple-mode analgesia consists of epidural administration of lidocaine,parecoxib intravenously and patient-controlled epidural analgesia (PCEA) on patients after thoracic surgeries. Methods Total 90 patients treated with thoracic surgeries were allocated into 3 groups by random digits table,each with 30 cases. Patients accepted 1% lidocaine 5 ml epidurally 5 min before incision in group A and B,and 5 ml saline as control in group C. When chest closing parecoxib 40 mg were given in group A,and 2 ml saline as control in group B and C. All the patients were given PCEA. Postoperative hemodynamics,dosage of remifentanil and analgetics of PCEA within 48 h, visual analogue scale (VAS) of pain, rescue of pethidine, duration for first pain calling,and satisfactory scores of patients, doctors and nurses were recorded. Results Dosage of remifentanil was lower [(0.72±0.26), (0.84±1.20) μg／(kg·min)], and duration for first pain calling was longer[(35.00±2.78),(12.09±6.27) min] in group A and B than that in group C significantly[(1.80±0.84) μ,g／(kg·min) and (5.95±3.65) min](P<0.05). Analgetics of PCEA with in 48 h in group A was lower than that in group B which was lower than that in group C[(180.40±20.48), (192.54±40.15), (220.26±36.78) ml](P< 0.05). No difference was found on VAS of pain and hemodynamics among three groups when patients were kept immobilized, but VAS of pain in group A and B was lower than that in group C when patients kept moving. Satisfactory scores of patients,doctors and nurses in group A were higher. Conclusion Epidural administration of 1% lidocaine combined with intravenous paiecoxib 40 mg and PCEA an offer satisfactory postoperative analgesia for patients after elective thoracic surgeries.
