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1.
预防丙泊酚注射痛的几种方法评估   总被引:1,自引:0,他引:1  
涂昕祥 《河北医学》2010,16(7):847-849
目的:比较芬太尼、利多卡因、托烷司琼3种药物预防丙泊酚注射痛的效果。方法:静脉麻醉患者120例,随机分为4组:Ⅰ组:静脉注射生理盐水2mL;Ⅱ组:静脉注射25μg/mL芬太尼2mL;Ⅲ组:静脉注射1mg/mL托烷司琼2mL;Ⅳ组:静脉注射2%利多卡因2mL,各组从静脉给予实验药物60s后,5 mg/s恒速推注丙泊酚,观察每组疼痛的发生率和程度。结果:与Ⅰ组(疼痛发生率80%)相比、Ⅱ组、Ⅲ组、Ⅳ组用药后疼痛发生率分别为37%、30%、33%,均可以明显降低丙泊酚静脉注射疼痛发生率(P〈0.05),而3个实验组间差异无统计学意义(P〉0.05)。结论:在丙泊酚注射之前60s,芬太尼50μg、托烷司琼2mg、利多卡因40mg的缓慢注射均可降低丙泊酚静脉注射痛的发生率。  相似文献   

2.
目的:雷米芬太尼复合丙泊酚应用于乳腺癌根治术的效果。方法:本研究选择ASAⅠ-Ⅱ级,乳腺癌根治手术的患者60例,随机分为芬太尼复合丙泊酚全凭静脉麻醉组(F组)和雷米芬太尼复合丙泊酚全凭静脉麻醉组(RF组)。所有患者麻醉前静脉滴注戊乙奎醚0.15mg/kg,予以神经安定咪达唑2mg、芬太尼0.1mg静脉滴注。结果:诱导后两组平均动脉压(MAP)和心率(HR)与诱导前比较明显下降(P<0.005),停药后患者清醒程度RF组强于F组(P<0.01)。结论:芬太尼与雷米芬太尼属于吗啡药,其中有眩晕、恶心、呕吐不良反应。尤其芬太尼不良反应较雷米芬太尼更甚,复合丙泊酚麻醉效果较好。  相似文献   

3.
王琛  袁志浩  刘卫军 《吉林医学》2012,33(25):5476-5478
目的:观察小儿麻醉诱导时预先注射瑞芬太尼复合利多卡因预防丙泊酚注射痛的效果。方法:150例拟行静脉麻醉诱导的患儿(3~9岁),随机分为瑞芬太尼[0.3μg(kg.min),持续60 s]复合利多卡因(0.5 mg/kg)预先注射组(Ⅰ组)、利多卡因预先注射组(Ⅱ组)或瑞芬太尼预先注射组(Ⅲ组),50例/组。记录丙泊酚注射痛评分、患儿应答、诱导前后血流动力学变化、患儿意识消失时间及该时刻丙泊酚用量、诱导期不良反应。结果:Ⅰ组注射痛发生率和严重程度显著低于Ⅱ、Ⅲ两组(P<0.005)。各组用药后血压均明显下降,Ⅰ、Ⅲ组心率亦下降,意识消失时间及该时刻丙泊酚用量无差异。结论:预防小儿丙泊酚注射痛,提前60 s预注0.3μg/kg的瑞芬太尼与预先注射利多卡因0.5 mg/kg效果相近,复合应用有助于改善后者的预防效果。  相似文献   

4.
目的:观察不同剂量芬太尼混合丙泊酚对丙泊酚注射痛的影响.方法:160例全麻手术患者随机分为四组,每组各40例.A组注射生理盐水2ml后注射丙泊酚5ml,B组注射芬太尼0.1mg后注射丙泊酚5ml,C组注射芬太尼0.1mg和200mg丙泊酚混合液5ml,D组注射芬太尼0.2mg和200mg丙泊酚混合液5ml,均以0.5ml/s的速度输注.使用语言评定量表(V-RS)评估丙泊酚注射痛的程度.结果:A组、B组、C组和D组患者注射痛发生率分别为95%(38/40)、80%(32/40)、38%(15/40)和10%(4/40).C组、D组患者注射痛发生率明显低于A组和B组(P<0.05);D组患者注射痛发生率明显低于C组(P<0.05).结论:丙泊酚200mg中加入0.1mg、0.2mg芬太尼可有效减轻丙泊酚注射痛,且加入0.2mg芬太尼的效果优于0.1mg.  相似文献   

5.
目的:探讨丙泊酚复合雷米芬太尼在结肠镜检查中的应用效果.方法:选择结肠镜检查患者1600例,随机均分为丙泊酚复合雷米芬太尼Ⅰ组和丙泊酚复合芬太尼Ⅱ组,记录诱导及苏醒时间,HR,SpO2,R,MAP.结果:Ⅰ组诱导及苏醒时间明显早于Ⅱ组(P<0.01),苏醒后Ⅰ组嗜睡、呕吐的发生率明显低于Ⅱ组(P<0.01),Ⅰ组诱导期躁动、检查中出现体动反应明显少于Ⅱ组(P0.05).结论:丙泊酚复合雷米芬太尼在结肠镜检查中的应用是可行的.  相似文献   

6.
目的通过不同剂量雷米芬太尼的使用,确定普通成人非肌松剂气管插管时的雷米芬太尼的合适剂量。方法66例择期手术病人,插管条件Ⅰ~Ⅱ级,ASAⅠ~Ⅱ级。平均分为3组。各组雷米芬太尼用量分别为2、3、4μg/kg;丙泊酚用量均为2 mg/kg。记录给药完成(T1)、插管后1 min(T2)、插管后4 min(T3)的SpO2(动脉血氧饱和度)、NIBP(无创血压)、HR(心率)。根据面罩控制通气满意度、下颌松弛度、声门状态、病人有否呛咳、体动等评定插管条件。结果1、2、3组插管条件临床可接受的比例分别为50%、82%和100%,1组与2组、3组相比差异均有统计学意义(P<0.05);1组严重呛咳、声门紧闭的发生率明显高于2组和3组(P<0.05)。各组给药前后MAP(平均动脉压)、HR相比差异均有统计学意义(P<0.05),但均在临床可接受范围。结论丙泊酚+雷米芬太尼非肌松剂气管插管的方法可以安全应用于临床,推荐剂量为丙泊酚2 mg/kg+雷米芬太尼3~4μg/kg。  相似文献   

7.
目的 比较阿芬太尼、瑞芬太尼预处理对丙泊酚注射痛的影响.方法 将175例需在全麻下进行妇科手术的成年女性患者随机分为四组:阿芬太尼(1 mg/2 mL)组(AL组,n=43)、瑞芬太尼(0.01 mg/2 mL)1组(REM1组,n=43)、瑞芬太尼(0.02 mg/2 mL)2组(REM2组,n=45)及生理盐水(2 mL)对照组(n=44),30 s后注射丙泊酚.根据患者的主观感觉进行疼痛模拟评分(VAS),并记录注药期间出现的所有不良反应.结果 REM2组和对照组各1例患者因静脉置管困难而排除.AL组、REM1组、REM2组三组患者出现的注射痛严重程度均明显轻于对照组(P<0.05),AL组在缓解丙泊酚注射痛上比REM1组和REM2组更有效(P<0.05),而REM2组在缓解丙泊酚注射痛上比REM1组有效(P<0.05).用药组的丙泊酚注射痛发生率均明显低于对照组(P<0.01).AL 组中有1例患者在注药后出现了恶心;REM2组中有1例患者在注药完成后出现恶心,1例患者在注药过程中出现会阴搔痒.结论 阿芬太尼与瑞芬太尼能有效缓解疼痛的发生.瑞芬太尼在预防丙泊酚注射痛时是有效的,且剂量应≥0.02 mg.  相似文献   

8.
目的 比较阿芬太尼、瑞芬太尼预处理对丙泊酚注射痛的影响.方法 将175例需在全麻下进行妇科手术的成年女性患者随机分为四组:阿芬太尼(1 mg/2 mL)组(AL组,n=43)、瑞芬太尼(0.01 mg/2 mL)1组(REM1组,n=43)、瑞芬太尼(0.02 mg/2 mL)2组(REM2组,n=45)及生理盐水(2 mL)对照组(n=44),30 s后注射丙泊酚.根据患者的主观感觉进行疼痛模拟评分(VAS),并记录注药期间出现的所有不良反应.结果 REM2组和对照组各1例患者因静脉置管困难而排除.AL组、REM1组、REM2组三组患者出现的注射痛严重程度均明显轻于对照组(P<0.05),AL组在缓解丙泊酚注射痛上比REM1组和REM2组更有效(P<0.05),而REM2组在缓解丙泊酚注射痛上比REM1组有效(P<0.05).用药组的丙泊酚注射痛发生率均明显低于对照组(P<0.01).AL 组中有1例患者在注药后出现了恶心;REM2组中有1例患者在注药完成后出现恶心,1例患者在注药过程中出现会阴搔痒.结论 阿芬太尼与瑞芬太尼能有效缓解疼痛的发生.瑞芬太尼在预防丙泊酚注射痛时是有效的,且剂量应≥0.02 mg.  相似文献   

9.
赵磊  王天龙 《北京医学》2010,32(8):633-636
目的观察不同剂量雷米芬太尼复合丙泊酚在无痛胃镜检查中的效果及可行性。方法选择100例ASAⅠ~Ⅱ级无痛胃镜检查患者,随机分为两组。麻醉用药方案,A组:丙泊酚1.5mg/kg+雷米芬太尼0.2μg/kg;B组:丙泊酚1.5mg/kg+雷米芬太尼0.4μg/kg;检查期间体动则追加丙泊酚0.5mg/kg;观察并记录入室(T0)、给药后2min(T1)、入镜后2min(T2)、退镜(T3)、苏醒时刻(T4)、离院前(T5)时刻平均动脉血压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)以及内镜检查时间、苏醒时间、定向力恢复时间、离院时间、疼痛视觉模拟评分(VAS)和麻醉效果。结果所有患者麻醉后MAP、HR、SpO2下降,离院前回升,其中SpO2在T2时刻最低(P〈0.01),分别为A组96.7%±2.8%、B组96.1%±3.6%。两组患者检查时间、苏醒时间、定向力恢复时间和离院时间均无显著性差异。B组麻醉效果明显优于A组(麻醉效果优占比96%vs.74%,P〈0.01),呼吸抑制例数明显多于A组(发生SpO2低于90%例数比16%vs.0,P〈0.01),但托下颌后均缓解。结论对于实施无痛胃镜检查的患者,采用丙泊酚1.5mg/kg联合雷米芬太尼0.4μg/kg实施静脉麻醉麻醉镇痛效果好,对呼吸循环抑制轻微,为较好的用药方案。  相似文献   

10.
雷米芬太尼复合丙泊酚麻醉应用于结肠镜检查临床观察   总被引:3,自引:0,他引:3  
目的探讨雷米芬太尼复合丙泊酚用于结肠镜检查患者的麻醉效果。方法80例接受结肠镜检查患者(ASAⅠ~Ⅱ级)随机均分2组,观察组应用雷米芬太尼加丙泊酚麻醉,对照组应用芬太尼加丙泊酚麻醉,观察记录心率、血压及血氧饱和度的变化,并记录体动反应。结果2组麻醉前心率、收缩压、舒张压、血氧饱和度比较均无显著差异(P>0.05),2组收缩压、舒张压和心率(对照组诱导后1 min时心率除外)麻醉诱导后1 min、5 min、10 min、15 min时与麻醉前比较均有显著性差异(P<0.05),观察组收缩压、舒张压及心率在麻醉诱导后1 min、5 min、10 min、15 min时明显低于对照组(P<0.05,1 min时SBP除外),而2组血氧饱和度比较无显著性差异(P>0.05),观察组患者术中体动反应发生率明显低于对照组(P<0.05)。结论等效价强度雷米芬太尼复合丙泊酚的镇痛效果强于芬太尼复合丙泊酚,更适用于无痛结肠镜检查术。  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

13.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

20.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

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