The Clinical Research On The Post-operative Analgesia In Intensive Care Unit(ICU) Of Thoracic Surgery Department

Objective: To investigate the post-operative analgesia of the patients in theintensive care unit of thoracic surgery department , and understand the clinical significance through the comparison of the clinical values . At the same time , there also have a contrast among the different analgesia methods .Methods: 45 patients scheduled thoracotomy were divided randomly into 3groups : intravenous-morphine analgesia group , epidural-morphine analgesia group , and the control group which received morphine through intramuscularly-injection . In this research , the preoperative and postoperative values were monitored and recorded , including artery blood gas analysis , lung function measurement , heart function measurement , lymphocyte counting , CD4+ /CD8+ , ICU retention stage , the postoperative complication , visual analogue scales (VAS values) , etc.Results: The patients in three groups have no statistic difference in the basicparameters of age , sex , weight and physical condition .1. Monitor and comparison of the postoperative visual analogue scales (VAS values) : Monitored and recorded the VAS values of three groups in three points : the 12th , 24th ,36th hour after the operation . There were no statistic differences among the values of these three points . However , the VAS values of intramuscularly-morphine analgesia group were statistically higher than the other 2 groups . 2. Monitor and comparison of heart function values : The main observation indexes were preoperative and postoperative systolic pressure , diastolic pressure , heart rate , which were measured in three points , the 24th hour before operation . the 1 2th and 24th hour after the operation .(1) Systolic pressure (SBP) : The outcome showed a higher postoperative pressure than the postoperative stage and has statisticmeaning (P<0.05) ; the comparison showed that the SBP of intramuscularly-morphine analgesia group was higher than the other 2 groups , and no statistic difference between the intravenous morphine analgesia group and epidural morphine analgesia group . ( 2 ) Diastolic pressure ( DBF ) : There were no statistic difference among the three observation points ; the comparison showed the diastolic pressure of the intramuscularly-morphine analgesia group was higher than the other 2 groups (P<0.05) , and no statistic difference between the other 2 groups . ( 3 ) Heart rate ( HR ) : The postoperative heart rates were higher than the preoperative values (P<0.05) ; the comparisons among three groups showed that the heart rate of intramuscularly morphine analgesia group was higher than the other 2 groups (P<0.05) , and no statistic difference between the other 2 groups . 3. Monitor and comparison of lung function : The main preoperative and postoperative observation indexes were the forced vital capacity (FVC) , the maximum vital capacity (MVV) , and the first second forced expiratory volume (FEV1) ? All the values of the groups were decreased markedly (P<0.05) , and the intramuscularly-morphine analgesia group was the lowest one . 4. Monitor and comparison of artery blood gas analysis : The main observation indexes were partial artery oxygen pressure (PaO2) ,partial artery carbon dioxide pressure (PaCO2) , oxygen saturation (SaO2) , the difference pressure between the alveolus and artery ( PA-aO2 ) , and measured at three points : the 24th hour before the operation , the 1 2th hour and 24th hour after the operation . The outcome showed that all the post-operation PaO2 of the groups decreased markedly (P<0.05) , and intramuscularly-morphine analgesia group decreased lower than the other 2 groups . There were no statistic difference of among the perioperation PaCO2 and SaO2% , but the values of intramuscularly-morphine analgesia group dropped more markedly than the other 2 groups . The post-operation PA-aO2 increased greatly ( PO.05 ) , however ,theintramuscularly-morphine analgesia group was the highest . 5. Monitor and comparison of the immunity funct...