Effects of PCIA and PCEA on Gastrointestinal Function Restoration in Patients Underwent Lower Limb Surgery

Objective To compare the effect of two commonly used methods for analgesia,PCIA and PCEA,on the gastrointestinal function of patients who received lower limb surgery.Methods Eighty patients who received elective lower limb surgery under general anesthesia were randomly selected,ASA Ⅰ-Ⅱ grade,18 to 45 years old,body weight were within standard body weight ± 10%.The 80 cases were divided into 4 groups,20 cases for each.Patients in group I received patient-controlled intravenous analgesia(PCIA) after surgery,divided into two sub-groups.group I1(tramadol hydrochloride+fentanyl citrate) and group I2(tramadol hydrochloride+fentanyl citrate+granisetron hydrochloride).Patients in group E received epidural analgesia(PCEA) after surgery.Patients in group C as control received intramuscular injection of pethidine hydrochloride 1 mg/kg as demand after surgery.The general situation,the recovery of gastrointestinal function(first exhaust time,the incidence of nausea and vomiting,bowel movement recovery time) and other projects were observed and recorded during the period of postoperative analgesia.Results In the comparison of postoperative gastrointestinal function of four groups,the first exhaust time of group E was significantly earlier than that of other groups(P0.05).The first exhaust time of group I2 was longer than of group I1 or group C,with the difference statistically significant(P0.05).The first exhaust time between group I1 and group C was not significantly different(P 0.05).The gastrointestinal motility recovery time of group E was significantly earlier than the others(P0.05).There was no significant difference between the remaining three groups(P0.05).The nausea and vomiting rate of group I1 in the first and second days after surgery was significantly higher than the other groups(P0.05),there was no significant difference between the remaining three groups(P0.05).No nausea and vomiting occurred on the third day after surgery in patients of each group.Conclusion Epidural analgesia can significantly enhance gastrointestinal functional recovery of patients after lower limb surgery.Granisetron can significantly reduce the occurrence of postoperative nausea and vomiting(PONV),but extend the onset time of postoperative exhaust