不同浓度舒芬太尼混合罗哌卡因行硬膜外镇痛的临床观察

目的 比较不同浓度舒芬太尼混合罗哌卡因用于术后持续硬膜外镇痛的镇痛效果及相关不良反应.方法 36例择期手术的妇科、泌尿科患者随机均分成3组,术后硬膜外镇痛分别使用舒芬太尼浓度0.75 μg/ml(A组)、1.0 μg/ml(B组)、1.25 μg/ml(C组)混合0.2％罗哌卡因.镇痛泵固定持续输注速度2 ml/h,于...     

患者耐受喉罩或气管导管时七氟烷的麻醉深度

Objective To compare the effects of patient's tolerance to laryngeal mask airway (LMA) and tracheal tube (TT) on the appropriate level of sevoflurane anesthesia.Methods Eighty ASA Ⅰ or Ⅱ patients aged 30-60 yr weighing 50-70 kg undergoing elective thyroid or breast surgery were randomly divided into 2 groups (n=40 each):LMA group and TT group.Anesthesia wag induced with propofol 1.6mg/kg,fentanyl 3μg/kg and recuronium 0.6mg/kg.LMA or tracheal tube was inserted,and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of 1.5%-3.0% sevoflurane and 50% N2O in O2 in group LMA,and with 2.5%-5.0% sevoflurane and 50% N2O in O2 in group TT.The flow of O2 and N2O was 0.7-1.0L/min,and the concentration of sevofluranee was adjusted to maintain AAI at 15-25.ECG,HR,MAP,SpO2,PETCO2,AEP and end-tidal sevoflurane concentration were continuonsly monitored.The end-tidal sevoflurane concentration was recorded at 1,5 and 10 min after LMA/TT was placed (T1-3),at 1h after skin incision (T4) and at the end of operation before removal of LMA or extubation (T5).The recovery time of consciousness,adverse cardiovascular events and adverse reactions were recorded.Results The end-tidal sevoflurane concentration was significantly lower,the recovery time of consciousness and removal of LMA or extubation time were shorter,and the incidence of adverse cardiovascular events and adverse reactions was lower in LMA group than in TT group.Conclusion At the same depth of anesthesia (AAI 15-25),sevoflurane concentration is significantly lower in LMA group than in TT group,with fewer complications and smaller cardiovascular reaction.     

内科护理纠纷常见原因分析及防范措施

目的 探讨内科护理纠纷常见原因及提出相应防范措施.方法 对内科护理纠纷进行原因分析,提出相应防范措施.结果 服务意识淡薄、违反操作规程、技术水平欠缺、护理文书书写不规范、护患沟通不到位是内科护理纠纷的常见主要原因,相应的防范措施可以减少护理纠纷的发生.结论 执行相应防范措施,提高护理服务质量,才能最终减少和避免内科护理纠纷的发生.     

脑血管病偏瘫患者的家庭康复护理

目的 通过对脑卒中后偏瘫患者进行家庭康复护理,探讨脑卒中偏瘫患者家庭康复护理的实施方法 和意义. 方法 选择脑卒中后偏瘫患者34例,制定个性化家庭康复护理计划,出院后从心理护理、肢体康复和语言康复三方面给予家庭康复护理. 结果 34例患者经过6个月家庭护理,各种功能得到不同程度的恢复,有21例患者生活基本达到自理,6例回归社会角色. 结论 家庭康复护理具有可操作性和可持续性,能够减轻患者致残率,提高患者及家庭的生活质量,有效减轻家庭和社会的负担.     

无输糖状态下术中血糖变化的观察

麻醉及手术中要否输入葡萄糖液 ?我们观察正常血糖病人 ,在麻醉前禁食 12小时 ,麻醉及手术中不输含葡萄糖溶液情况下的血糖变化 ,旨在指导手术中的输液。资料与方法一般资料　选择ＡＳＡⅠ～Ⅲ级择期手术病人 96例 ,年龄 15～ 83岁 ,全部为上午 8时手术病人。确认其 :(1)空腹血     

经硬膜外与经静脉应用芬太尼临床麻醉效果的比较

硬膜外持续输注芬太尼已广泛用于临床 ,但硬膜外给芬太尼是否比静脉途径更有临床优越性 ,目前存在较大争议[1,2 ] 。本文对比观察乳腺癌根治术中 ,硬膜外或静脉途径应用芬太尼对血流动力学、麻醉药需要量、血糖以及麻醉恢复期的影响 ,以探讨硬膜外应用芬太尼的临床应用价值。资     

肿瘤性疼痛16例诊断经验

疼痛性疾病治疗,必须有明确的诊断。单纯治疗症状,容易贻误病情。本文对1987～1992年5年中16例以疼痛就诊我科,在首诊或二诊中被确诊为肿瘤的病例作一回顾。     

氯普鲁卡因在下腹部手术麻醉的应用

盐酸氯普鲁卡因是一种短效局部麻醉药。国内已有文献报道，3％氯普鲁卡因用于硬膜外麻醉行产科或下腹部手术的麻醉。我们采用低浓度即1．5％氯普鲁卡因用于硬膜外麻醉，现报道如下。