吸烟者胸部手术后自控静脉镇痛效果观察

摘要

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 pa-tients 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 re-lated 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 tran-quillization 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 non-smokers, 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 .%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。