CAJ | 학술논문

目的：探讨超前镇痛对老年结直肠肿瘤腹腔镜手术患者进行快通道麻醉后的复苏质量的影响。方法选取于2013年7月至2014年5月在我院进行腹腔镜手术治疗的80例结直肠肿瘤患者，根据患者入院治疗的先后顺序均分为观察组和对照组各40例。观察组患者实施超前镇痛，对照组患者则不实施超前镇痛，比较两组患者术后恢复意识时间、拔管时间、复苏阶段不良事件发生率及苏醒期的躁动程度(RS)、拔管后的疼痛(VAS)、拔管后的镇静状况(Ramsay)评分。结果观察组患者术后恢复意识时间及拔管时间与对照组比较差异均无统计学意义(P>0.05)，且观察组患者的Ramsay评分明显高于对照组，而VAS评分及RS评分均明显低于对照组，两组比较差异均具有统计学意义(P<0.05)。观察组患者术后呼吸困难、呻吟、躁动、拔管知晓、恶心呕吐发生率明显低于对照组，两组比较差异均有统计学意义(P<0.05)。结论超前镇痛应用于快通道麻醉后效果显著，复苏安全有效，减少了苏醒期的躁动及麻醉后引起痛觉的高敏，还使拔管阶段不良事件的发生率降低。
목적：탐토초전진통대노년결직장종류복강경수술환자진행쾌통도마취후적복소질량적영향。방법선취우2013년7월지2014년5월재아원진행복강경수술치료적80례결직장종류환자，근거환자입원치료적선후순서균분위관찰조화대조조각40례。관찰조환자실시초전진통，대조조환자칙불실시초전진통，비교량조환자술후회복의식시간、발관시간、복소계단불량사건발생솔급소성기적조동정도(RS)、발관후적동통(VAS)、발관후적진정상황(Ramsay)평분。결과관찰조환자술후회복의식시간급발관시간여대조조비교차이균무통계학의의(P>0.05)，차관찰조환자적Ramsay평분명현고우대조조，이VAS평분급RS평분균명현저우대조조，량조비교차이균구유통계학의의(P<0.05)。관찰조환자술후호흡곤난、신음、조동、발관지효、악심구토발생솔명현저우대조조，량조비교차이균유통계학의의(P<0.05)。결론초전진통응용우쾌통도마취후효과현저，복소안전유효，감소료소성기적조동급마취후인기통각적고민，환사발관계단불량사건적발생솔강저。
Objective To investigate the impact of preemptive analgesia on the quality of resuscitation in el-derly patients with colorectal cancer after laparoscopic surgery under fast-track anesthesia. Methods Eighty elderly patients with colorectal cancer received laparoscopic surgery under fast-track anesthesia in our hospital from July 2013 to May 2014 were enrolled in the study, which were divided into the observation group (40 cases) and the control group (40 cases) according to the order of admission. Patients in the observation group received preemptive analgesia, while the control group did not. The two groups were compared in time of recovering consciousness, extubation time, incidence of adverse events during resuscitation, agitation level (RS) after resuscitation, pain after extubation (VAS score), sedation status after extubation (Ramsay score). Results Time of recovering consciousness and extubation time showed no statistically significant difference between the two groups (P>0.05). The observation group was signif-icantly higher in Ramsay score, but significantly lower in VAS score and RS scores, compared with the control group (P<0.05). The observation group was significantly lower in the incidence of postoperative respiratory difficulty, moan-ing, restlessness, extubation awareness, nausea and vomiting than the control group (P<0.05). Conclusion Preemp-tive analgesia for fast-track anesthesia results in significant anesthetic effect and safe resuscitation, which reduces the anesthesia-caused agitation and pain of high sensitivity, and lowers the incidence of adverse events during extubation.