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目的 :对患者自控镇痛 (PCA)使用或不使用背景灌注 (CI)两种镇痛模式进行观察比较.方法 :4 0例ASAⅠ或Ⅱ级腹部手术后患者 ,随机分为不使用背景灌注的PCA组与使用背景灌注的PCA +CI组 ,每组 2 0例 ,以吗啡作镇痛剂 ,观察两组的临床疗效 ,并测定血清吗啡浓度.结果 :两组在镇痛效果 (VAS均低 )及夜间睡眠上均满意 ;2 4小时吗啡总用量 (2 3 5 6± 13mg和 2 8 91± 13 88mg) ,最低有效吗啡血清浓度 (变化在 17 2~ 3 9 7ng/ml及 2 1 8~3 9 5ng/ml之间 )及HR、BP、RR、VT、SpO2 两组间变化相似 (P >0 0 5 ) ;而吗啡用量的个体差异较大 (3 5 6~ 4 9 76mg及 13 3 8~ 61 72mg) ;副作用恶心呕吐各为 4例和 6例 ,PCA +CI组 1例皮肤瘙痒 ,无临床呼吸抑制病例.结论 :PCA及PCA联合低剂量CI两种镇痛模式均是术后镇痛的安全有效方法.“,”Objective:Patient controlledanalgesiawithorwithoutcontinuousinfusionmethodswasstudied .Methods: Fourtyadultpatients (ASAⅠorⅡ )undergoingelectiveabdominalsurgery ,weredividedrandomlyintotwogroups (n =2 0 ) :PCAgroup (0 0 1mg/kg ,lock out 5min .limitdose 0 0 6mg·kg-1·h-1) .PCA +Clgroup(PCACombinedwithCon tinuousinfusion 0 0 1mg·kg-1·h-1) .Serummorphineconcentrationwasdetermined .Results:Analgesia (lowVAS)and nightsleepweresatisfactoryinbothgroups (P >0 0 5 ) ,andhadnosignificantdifferencein 2 4hmorphinetotalconsumption(2 3 5 6± 13mgand 2 8 91± 13 88mg) ,bloodconcentrationsofmorphine (17 2~ 3 9 7ng/mland 2 1 8~ 3 9 5ng/ml) , HR ,BP ,RR ,VTandSpO2 betweentwogroups (P >0 0 5 ) .However ,therewasagreatdealofindividualvariationin morphine 2 4hconsumption (3 5 6~ 4 9 76mgand 13 3 8~ 61 72mg) .Nausea/vomitingoccurredin 4 patientsofPCAgroupand 6patientsofPCA +CIgroup ,pruritusoccuredin 1patientofPCA +CIgroup .Norespiratorydepressionwasobserved .Conclusion :Forpostoperativepainrelief,bothofPCAandPCA +CImethodsaresafeandeffective .