CAJ | 학술논문

目的：探讨老年患者开胸术后镇痛对应激反应的影响。方法对72例老年患者随机分为两组，在麻醉恢复后( A组)、拔管后( B组)开放静脉自控镇痛泵( PCIA)。比较两组术后疼痛差别及应激反应等情况。结果 A组术后12 h疼痛视觉模拟评分( VAS)和血糖低于B组，同时A组术后24 h、48 h氧合指数高于B组，差异均有统计学意义(P<0．05)。结论开胸术后的老年患者在麻醉清醒时打开镇痛泵可降低术后应激反应水平，对呼吸无明显抑制。
목적：탐토노년환자개흉술후진통대응격반응적영향。방법대72례노년환자수궤분위량조，재마취회복후( A조)、발관후( B조)개방정맥자공진통빙( PCIA)。비교량조술후동통차별급응격반응등정황。결과 A조술후12 h동통시각모의평분( VAS)화혈당저우B조，동시A조술후24 h、48 h양합지수고우B조，차이균유통계학의의(P<0．05)。결론개흉술후적노년환자재마취청성시타개진통빙가강저술후응격반응수평，대호흡무명현억제。
Objective to evaluate the effect of patient controlled intravenous analgesia ( PCIA) on stress re-sponse in elderly patients with open thoracic surgery. Methods 72 elderly patients were randomly divided into two groups. PCIA was opened after anesthesia awake ( group A) or after extubation ( group B) respectively. Analgesic effect and stress reaction were assessed. Results 12 h visual analogue scale and blood glucose in group A was nota-ble significant lower than group B. Meanwhile, 24 h and 48 h oxygenation index after surgery in group A was notable higher than group B. Conclusions PCIA should be opened as soon as possible after anesthesia awake. It could re-duce stress levels without respiratory depression.