Objective To investigate the clinical effects of introvenious analgesia pump and epidural analgesia pump in preventing bladder spasm of patients after PKRP and find an effective, safe and simple analgesia method. Methods 168 patients with epidural analgesia pump and 82 patients with introvenious analgesia pump after PKRP in our hospital from September of 2008 to August of 2011 were retrospectively analyzed. The two methods were evalu-ated by effect of preventing bladder spasm, safety, complications. Results For patients in the epidural analgesia pump group, 80 patients had bladder spasm. including rebleeding in 42 patients, 8 patients of transurethral endoscopic hemostasis again, 2 patients of open operation suture bladder neck. complications in 21 patients, 12 patients of diziness, nausea, vomiting;hypotension in 7 patients;2 patients of epidural hematoma ,1 patient had significantly lower limb numbness;1 patient of catheter fracture and detention. For patients in introvenious analgesia pump group, only 9 patients had bladder spasm, 2 patients of spastic hemorrhage, 1 patient of reoperation after transurethral endoscopic hemostasis,no one underwent open operation bleeding. Only 2 patients had mild nausea, vomiting, no patient of hypotension, dizziness, numbness in the lower limbs. Conclusion Introvenious analgesia pump was more effective than epidural analgesia pump in preventing bladder spasm after PKRP. The former merited to be extensively used due to simple, safe and effective, less side effects and complications.% 目的总结静脉镇痛泵与硬膜外镇痛泵在防治PKRP术后膀胱痉挛中的临床疗效,初步比较两种方法的效果与不足,从而为寻找一种更有效、安全、简便的术后镇痛方法提供参考。方法收集我院2008年9月至2011年8月PKRP术后留置硬膜外镇痛泵病人168例,留置静脉镇痛泵病人82例,从术后抑制膀胱痉挛的疗效、安全性、并发症等方面比较两种方法的优缺点。结果硬膜外镇痛泵组术后出现明显膀胱痉挛80例,42例出现痉挛性出血,8例再次电切镜下止血,2例开放手术缝合膀胱颈。出现各种并发症21例：头晕、恶心、呕吐12例；低血压7例；硬膜外血肿2例,其中1例有明显下肢麻木；导管断裂滞留1例。静脉镇痛泵组术后出现膀胱痉挛仅9例,2例出现痉挛性出血,1例再次经电切镜下止血,无1例行开放手术止血。仅2例出现轻度恶心、呕吐,无一例出现低血压、头晕、下肢麻木。结论静脉镇痛泵在防治PKRP术后膀胱痉挛中比硬膜外镇痛泵更具疗效,能有效抑制膀胱痉挛、减少再出血并降低再次手术率,具有安置简便、安全可行、疗效确切、副作用和并发症少的优越性,值得推广应用。
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