| Objective:Painful stimuli can be caused by spinal cord reflex arcreflex gastrointestinal function suppression. Pain stimulus occurs thestress response, catecholamines (Catecholamine, CA) and increasedcortisol secretion caused by sympathetic activity is increasedabnormally excessive contraction of blood vessels. Lead togastrointestinal ischemia and hypoxia injury [1-2]. Since thepatient-controlled analgesia (patient-controlled analgesia, PCA) wascarried out in the1970s, the technology matures and improve theincreasingly widespread clinical application. Postoperative analgesia toreduce pain, wound healing, reduce postoperative complications, andhelp to improve the surgical success rate and many other advantages,has become increasingly clinically acceptable [3]. But there are manyliterature reports of opioid analgesic effect also can produce respiratorydepression, such as nausea, vomiting, urinary retention and itchy skinadverse reactions, such as Liu [4] and Wingfull [5] observed. A greaterimpact on patients is the impact of gastrointestinal function.Postoperative analgesia to promote or inhibit the recovery of gastrointestinal function, and reports were available [6]. This studyintends to explore the patient-controlled analgesia (patient controlledanangesia PCA) on the non-gastrointestinal surgery in patients withpostoperative analgesia on gastrointestinal function and acupointinjection (foot injection metoclopramide) to its adjustment role.Understanding of different postoperative analgesic techniques ongastrointestinal function, in order to select and develop a reasonableand economic postoperative analgesia program guide clinicalstandardized postoperative analgesia.Methods:1.Select80cases of non-gastrointestinal surgerypatients, ASA I~II level,18to45years of age, body weight40~70kg,normal development of the heart, lung, liver, kidney and other organfunction, body weight±10%standard weightrange of gastrointestinaldiseases, neuropsychiatric disease, endocrine disease, no long-termsedation, analgesic drug application history, no history of alcohol abuse,Hb>80g/L, and normal coagulation surgery in patients with stablevital signs, noanesthesia and patients under general anesthesia withoutlocal anesthetic toxicity and too high level of anesthesia, anesthesia inpatients after recovery of consciousness, in line with the cases of theabove conditions into the observed2.Select non-gastrointestinal surgerypatients80cases were divided into4groups (n=20cases) I1(tramadol hydrochloride+citrate, sufentanil) group of non-patients under general anesthesia immediately after surgery administeredgeneral anesthesia, the patient awake after dosing. I2(tramadolhydrochloride more+citrate, sufentanil+Zusanli injectionmetoclopramide) group of non-anesthesia in patients afteradministration immediately clear after administration of generalanesthesia. I3(tramadol hydrochloride more+the citrate Fenshufentanyl+Zusanli acupoint injection of normal saline) group ofnon-anesthesia patients after immediate administration of anesthesia,the patient awake administration. I4(tramadol hydrochloride more+citrate, sufentanil+metoclopramide intramuscularly), non-anesthesiain patients after administration immediately clear after administrationof general anesthesia.Results:1.First exhaust the time, comparison of the incidence ofnausea and vomiting I1(20patients in the tramadol+citrate, sufentanil)group,8cases of postoperative vomiting. The first two cases after48hours, the remaining18cases the first time, killing time of the killingtime in the24±4hours. I2(tramadol hydrochloride more+citrate,sufentanil+Zusanli injection metoclopramide) group20patients thefirst time killing time after14±2hours. I3(tramadol hydrochloride+the citrate Fenshu fentanyl+Foot Three Mile hole injection of normalsaline) group20patients in the three cases of vomiting. After surgeryfor the first time a large number of postoperative19±2hours. I4 (tramadol hydrochloride more+citrate, sufentanil+metoclopramideintramuscularly) two cases of postoperative vomiting after the firsttime, killing time after surgery for postoperative18±2hours. Theresults show that the postoperative first exhaust time I2group wassignificantly shorter than in I1, I3, I4group; I3, I4was significantlyshorter than the I1group; no significant differences between the I3, I4group..2.Analgesic and sedative effect: Group I1vsa score of3-5points, four cases of patients with irritable. I2group vsa34points, nocase of postoperative restlessness. I3vsa3-5after2patients appearirritable. I4group vsa3-5after4patients appear irritable. The resultsshowed that the I2, I3group appeared the irritability cases less than I1,I4group.3.Motilin (Motilin MTL) comparison: I1preoperative motilin(MTL)300.27±40.08pg/ml The postoperative4:0045.71±9.86pg/mlThe eight hours after122.12±41.07pg/ml The12hours after270±42.67pg/ml. I2group preoperative motilin (MTL) prime308.21±43.33pg/ml The,55.79±I1.20pg/ml after4,8hours after200.22±43.07pg/ml12hours after340.51±42.19pg/ml. I3Group ofpreoperative gastric motilin (MTL)308.68±43.16pg/m, after4hours,50.11±I0.32pg/ml after8hours184.67±42.91pg/ml,12hours after335.12±43.17pg The/ml. MTL the I4Group of preoperativehormone (MTL)310.68±42.16pg/ml, after4hours,53.79±I2.20pg/ml eight hours after164.08±40.98pg/ml12hours after300.55 of±38.67pg/ml.. The data show that four groups of patients withpreoperative motilin (MTL) no significant difference (P>0.05) after8hours no significant difference (P>0.05) after12hours weresignificantly different (P <0.05）。Conclusions:1. postoperative acupoint injection stomachcomplex (Zusanli acupoint injection, ZSLAI) security combined withPCA to use to promote gastrointestinal tract ahead of the exhaust,promoting postoperative recovery of gastrointestinal function, reducepostoperative analgesic function of the gastrointestinal tractinhibition.2.acupuncture foot after three years (ZSLAI) can promote the body torelease of motilin, and promote the recovery of postoperativegastrointestinal function.3. acupuncture foot three years (ZSLAI) has acertain degree of sedation, acupuncture foot of Three Milecompatibility PCA to reduce postoperative irritable symptoms.4.Zusanli injection (ZSLAI), metoclopramide combined with PCA is areasonable and cost postoperative analgesia program. |
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