Process Management Of Analgesia After Thoracic Surgery

Objective:The pain is a tissue injury or unpleasant feeling or emotion caused by potential tissue damage experience. Postoperative pain is an immediate acute pain after surgery is a common clinical symptom, need timely treatment. In all types of surgery, thoracic surgery the pain is particularly intense, it has also become one of the major causes of the fear of patients undergoing thoracic surgery. Postoperative analgesia after thoracic surgery is affected by many factors:1, incomplete analgesia, patient affected by breathing pain, afraid to breathe and cause atelectasis, lung collapse, atelectasis; 2, excessive sedation the patient, confusion, poor communication and delayed observation; 3, cough and central inhibition of opioid analgesics caused by sputum hyporeflexia, leading to lung infection. Therefore, a lot of thoracic surgeons prefer not to keep the analgesia of patients with sputum excretion How to reasonable reflection. Analgesic therapy is the hot topic in acute pain management after thoracic surgery.Method:This topic through more traditional intravenous analgesia (non steroidal, opioid), sufentanil TCI-intraoperative PCA analgesia, used in postoperative analgesia after thoracic surgery, evaluation their impact on the patient, increased after thoracic surgery analgesia is a safe and effective. Better the process of analgesia after thoracic surgery in clinic.Results:(1) safety:Table 2, table 3, table 4, table 5 shows that the blood pressure, heart rate, respiration, oxygen saturation of the blood pressure after the start of analgesia, but all in the normal range. such as Figure 3, figure 4, figure 5, shown in Figure 6, start analgesia after T0, T1, T4, blood gas values, pH value gradually increased, pCO2 decreased gradually, T4, so far are fluctuations in the normal range.PO2 and oxygen and index were normal. Can illustrate four different analgesic methods are safe. (2) effectiveness as shown in Table 1, Figure 6, Prince-Henry, D, A group T1-5, group T1-5, B, T7, C group T3, T7 group T0, group T1-T8 time point, there was statistical difference (lower than TO). Comparison between the two groups:D group T1-T8 point in time and A, B, C group compared to the analgesic score was low, there was a statistically significant difference. As shown in Table 2, Figure 7, after the start of analgesia group Ramsay sedation score, compared with TO group, A group T2-4, group B, group T5-7, group T1-3, T7, D, T1-T8 group C time point, there were statistically significant differences (higher than TO). The four groups of patients with Ramsay sedation score group comparison, T5 group D, T6, T7, T8 and A, B, C three groups compared to have obvious statistical difference. D group of patients with Ramsay sedation score decreased significantly compared with A, B, C group. The patient can wake up in the range, there is no sedative excessive, delay the patient’s condition after the operation (3) The need to remedy the pain in the process:A group of 2 patients after remedial injection of tramadol 3 times, 3 patients were injected tramadol 2.B, C, D did not appear. Because A group needs to rescue many times, in order to achieve postoperative analgesia, so in the whole process of analgesia, the first is eliminated.(4) Comparison of economic benefits of B, C, D three groups analgesia device:Group C with dezocine analgesia device of high cost, large amount, the economic benefit is lower than B, D two groups. They are optimized in this process. (5) B, C, D three groups of patients with pain after the comparison of the number of times:In group D, there was no need to press the number of times than C, B group, the difference was statistically significant, that is, D group of patients with less interference. (6) Adverse event types and their incidence:Four groups of postoperative adverse reactions:nausea and vomiting in group A in 1 cases (10%), B group 1 patients (10%), group D in 1 case (10%), dizziness, group C 1 cases (10%) of the four groups of no statistical significance (P> 0.05); all patients had not appeared, skin itching, movement disorders, respiratory depression and other adverse reactions. (7) Satisfaction rate:comprehensive satisfaction score.The overall satisfaction of the four groups of postoperative analgesia device:A group satisfaction (satisfaction) 70%, B, C, D three groups with a satisfactory rate of 100%Conclusion:Sufentanil PCA-TCI for postoperative analgesia after thoracic surgery, economic security, without increasing side effects, suitable for in Thoracic Postoperative Analgesia process management...