Preliminary study to effects of patient-controlled intravenous analgesia for the early respiration and circulation of chest trauma

TIAN Jun; LIU Ming-hua

doi:10.3969/j.issn.1009-4237.2015.05.010

Abstract：Objective To observe the influence of patient-controlled intravenous analgesia( PCIA) on early respiration and circulation in patients with chest trauma. Methods From Oct.2010 to Jun.2011,26 cases of closed chest trauma who were admitted into the trauma emergency center of Southwest Hospital were randomly divid-ed into two groups,the control group,( n=11,no analgesia) and the analgesia group ( n=15,with controlled intra-venous analgesia for three days).In the control group,10 were males and 1 was female with an average age of (36.65 ±8.40)years (25-47 year).In the analgesia group,12 were males and 3 were females with an average age of (35.28 ±9.73)years (23-48 year).PH value,PO2,PCO2,SpO2,PaO2/FIO2,heart rate (HR),arterial elbow systolic blood pressure,myocardial enzymes in the aspartate aminotransferase( AST) ,creatine kinase ( CK) ,creatine kinase isoenzyme(CK-MB),lactate dehydrogenase (LDH),α-hydroxybutyrate dehydrogenase (α-HBDH) on ad-mission (0h),24h,48h,72h,96h and 120h were measured and analyzed. Results Two groups had no significant improvement in PO2 and oxygenation index at the time point of 24h and 48h without significant difference between the two groups(P>0.05).At the time point of 72h,96h and 120h,significant differences were observed between the two groups(P<0.05) in PO2 and PaO2/FIO2(control group:105.8 ±28.4/221.5 ±28.7,108.4 ±30.7/239.4 ± 25.3,142.8 ±34.3/318.5 ±35.7;analgesia group:131.8 ±27.5 /285.5 ±32.7,153.4 ±32.4/328.1 ±30.6, 170.8 ±20.7 /350.2 ±34.9) ,while PH value,PCO2 and SpO2 had no significant difference ( P>0.05) .HR at each time point had significant differences between the two groups( P<0.05);systolic blood pressure and myocardi-al enzyme test results had no significant difference between the groups(P>0.05).Conclusion Early analgesia for chest trauma has good therapeutic effect in restoring respiratory function and stablizing heart rate while having no significant effect on blood pressure and abnormal changes in myocardial enzymes.