Intravenous Patient-controlled Epidural Analgesia On The Comfortable Situation Of Thoracic Surgical Patients

In rencent years,thoracic patients accepted operation are increasing quicklybecause of the smoke, environment pollution,et al.These patients have more seriouspain and discomfort than other patients after operation due to the anatomy of chest.Patient-Controlled Analgesia (PCA) has become an acceptable and highly effectivemeans of relieving post-operative pain.In this research,investigator want to knowwhich routes could reduce the suffering of postoperative patients and increase thelevel of comfort, with i.v.PCA or epidural PCA.Objective:1)To describe the status about comfort of postoperative thoracicpatients who use of i.v.PCA in 24h and 48h after operation respectively.2) To describethe status about comfort of postoperative thoracic patients who use of epidural PCA in24h and 48h respectively also.3)Compare the differences of these two groups.Method:A questionnaire(General Comfort Questionnaire,GCQ) was used toinvestigate postoperative thoracic patients' comfort level in 48h after operation.Seventy six postoperative thoracic patients were randomly devided into two groups:i.v. PCA group or epidural PCA group. VAS score of these patients at 12h,24h,36h,48h after operation and adverse effects were recorded. 74 patients completed thestudy, and analysis of the data was achieved using the software SPSSI3.0 package.Results: 1)At 12h,24h,36h,48h after operation, mean VAS score of those patientsusing i.v. PCA is 2.41/5.14/7.00,2.38/4.76/6.73,1.14/3.97/6.16,1.05/3.43/5.24 whenthey were resting, moving and coughing. Corresponding mean VAS score of thosepatients using epidural PCA is 2.59/5.04/6.20,2.02/4.30/5.75,0.95/3.64/5.01, 0.78/3.08/4.43. VAS score of patients using epidural PCA is lower than those using i.v. PCAwhen they were coughing. 2)The mean score of GCQ of those using i.v.PCA is75.84,87.97 at 24h and 48h after operation. And the patients using epidural PCA got78.27,88.05 at 24h and 48h after operation. The level of comfort is middle for all ofpatients.3)The mean score of physical comfort for patients using epidural PCA ishigher than those using i.v.PCA.Conclusion:1) The effect of epidural PCA is better than i.v. PCA when post- operative thoracic patients are coughing. 2)The level of physical comfort for usingepidural PCA patients is higher than those patients using i.v.PCA.3) There were nostatistically differences among these two groups at psychological,social andenvironmental comfort levels.