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首页> 外文期刊>American journal of therapeutics >Effects of Patient-Controlled Epidural Analgesia and Patient-Controlled Intravenous Analgesia on Analgesia in Patients Undergoing Spinal Fusion Surgery
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Effects of Patient-Controlled Epidural Analgesia and Patient-Controlled Intravenous Analgesia on Analgesia in Patients Undergoing Spinal Fusion Surgery

机译：自控硬膜外镇痛和自控静脉镇痛对脊柱融合手术患者镇痛的影响

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We compared the outcomes of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) in analgesia after spinal fusion surgery. A total of 120 patients who underwent spinal fusion surgeries between April 2013 and April 2015 at Shaanxi Provincial People's Hospital were selected for this study based on defined inclusion criteria. All patients were randomly divided into 2 groups before surgery: PCEA group (n = 65) and PCIA group (n = 55). Visual analog scales (VAS) were used to evaluate the degree of pain. Besides, the active and passive activities of patients during 1- to 3-day recovery period after surgery were recorded. Verbal rating scales were used to measure pain levels after surgery and after surgery. Adverse effects of PCEA and PCIA were monitored, which included nausea, vomiting, pruritus, drowsiness, respiratory depression, and headache. Our results showed no statistically significant differences between PCEA and PCIA in sex ratio, age, height, weight, American Society of Anesthesiologists level, surgery time, number of fusion section, surgery methods, and duration of anesthesia (all P > 0.05). The PCEA group was associated with significantly lower VAS scores, compared with the PCIA group, at 3, 6, 12, 24, and 48-hour postsurgery (all P < 0.05) when surgery-associated pain is expected to be intense. Also, compared with the PCIA group, the PCEA group showed higher frequency of recovery activities on first and second day postsurgery (all P < 0.05). The overall patient satisfaction level of analgesia in the PCEA group was significantly higher than in the PCIA group (P < 0.05). Moreover, the incidence of hypopiesia and skin itching in the PCIA group was higher than in the PCEA group (all P < 0.05). Finally, drowsiness and headache were markedly lower in the PCIA group after surgery, compared with the PCEA group, and this difference was statistically significant (all P < 0.05). Our results provide strong evidence that PCEA exhibits significantly greater efficacy than PCIA for pain management after spinal fusion surgery, with lower VAS scores, higher frequency of recovery activities, and overall higher satisfaction level.
机译：我们比较了脊柱融合手术后患者自控硬膜外镇痛（PCEA）和自控静脉内镇痛（PCIA）的结局。根据确定的纳入标准，选择2013年4月至2015年4月在陕西省人民医院接受脊柱融合手术的120例患者作为研究对象。所有患者术前随机分为两组：PCEA组（n = 65）和PCIA组（n = 55）。使用视觉模拟量表（VAS）评估疼痛程度。此外，还记录了术后1至3天恢复期患者的主动和被动活动。口头评定量表用于测量手术后和手术后的疼痛程度。监测PCEA和PCIA的不良反应，包括恶心，呕吐，瘙痒，嗜睡，呼吸抑制和头痛。我们的结果表明，PCEA和PCIA在性别比，年龄，身高，体重，美国麻醉医师学会水平，手术时间，融合节数，手术方法和麻醉持续时间方面无统计学差异（所有P> 0.05）。与PCIA组相比，PCEA组在术后3、6、12、24和48小时的手术相关疼痛预计会加剧时，其VAS评分显着降低（均P <0.05）。另外，与PCIA组相比，PCEA组在术后第一天和第二天的恢复活动频率更高（所有P <0.05）。 PCEA组的总镇痛患者满意度水平明显高于PCIA组（P <0.05）。此外，PCIA组的低血尿症和皮肤瘙痒的发生率高于PCEA组（所有P <0.05）。最后，与PCEA组相比，PCIA组术后的嗜睡和头痛明显减少，且差异具有统计学意义（所有P <0.05）。我们的结果提供了有力的证据，表明在脊柱融合手术后的疼痛处理中，PCEA的疗效显着高于PCIA，其VAS评分更低，恢复活动的频率更高，总体满意度更高。

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