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《Chinese Journal of Clinical Rehabilitation》 2005-02
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Effects of different patient controlled analgesic methods on circulative functi on in hypertensive patients after upper abdominal surgery

Liu Xiao rong,Wang Yan lin,Wang Cheng yao Liu Xiao rong,Wang Yan lin,Wang Cheng yao,Department of Anesthesiology,Zhon gnan Hospital of Wuhan University,Wuhan 430071,Hubei Province,China  
AIM:To observe the effects of different patient controlled analgesic methods on levels of plasma endothelin(ET) and atrial natriuretic polypeptide(ANP), bloo d pressures, heart rate and analgesic effect in patients with complicated hypert ension after upper abdominal operation so as to provide a theoretical basis for the selection of optimal analgesic methods for the postoperative patients. METHODS: Thirty patients complicated with hypertension scheduled for upper abd ominal surgery in Zhongnan Hospital of Wuhan University during May 2003 and May 2004 were selected.Then,the patients were randomly divided into three groups acc ording to different analgesic methods after operation with 10 cases in each grou p: control group(Intramuscular injection of pethidine was given intermittently); patient controlled epidural analgesia(PCEA) group and patient controlled intra venous analgesia(PCIA) group. The levels of plasma ET and ANP were measured befo re anesthesia,0,24 and 48 hours after operation with radioimmunoassay;Meanwhile, blood pressures and heart rate were observed.Visual analog scale(VAS) was assess ed after operation. RESULTS:The heart rate, blood pressures and VAS were significantly lower in th e PCEA and PCIA groups than in the control group(t=2.38 to 11.26,P 0.05), and l ower in the PCEA group than in the PCIA group(t=2.53 to 4.26,P 0.05).Within 24 hours after operation,the levels of plasma ET and ANP in the PCEA and PCIA group s were significantly lower than those in the control group(t=2.35 to 9.23,P 0.0 5),and even lower in the PCEA group than in the PCIA group(t=3.01 to 6.21,P 0.0 5). At 48 hours after operation,the levels of plasma ET in the PCEA and PCIA gro ups were still lower than those in group the control group(t=2.65,3.27 P 0.05), but it was not significantly different between the PCIA group and control group. CONCLUSION:For patients with hypertension after upper abdominal operation, pat ient controlled analgesia can relieve postoperative pain,improve the circulativ e function,depress the postoperative levels of plasma ET and ANP,decrease postop erative complications,and benefit recovery of circulative function,so PCEA has a better effect.
【CateGory Index】: R614
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