Intravenous or rectal administration of sedatives in outpatient oral surgery

A number of cross-over studies on sedation in outpatient oral surgery investigated the quality of sedation produced by intravenous or rectal administration of diazepam. The sedation methods were equally efficient with a mean dose of 0.24 mg/kg (range 0.1–0.4) for i.v. administration and 0.53 mg/kg (range 0.5–0.6) for rectal administration. Eighty-five percent of the patients preferred surgery under sedation and local anaesthesia to local anaesthesia alone. The patients preferred the session in which they experienced stronger sedation, regardless of the route of administration.     

The effect of diclofenac and nefopam on postoperative dental pain

Eighty-two outpatients who received general anaesthesia for surgical removal of maxillary or mandibular third molars were given either diclofenac 75 mg or nefopam 20 mg intramuscularly for postoperative pain control. They and the control group were also allowed oral paracetamol as required. The results showed that there was no significant pain relief from these single intramuscular injections.     

Bioavailability of intramuscularly administered tenoxicam

Bioavailability of intramuscularly administered tenoxicam relative to single oral and relative to intravenous doses was determined in two separate randomized crossover studies. Twelve healthy volunteers (12 males, age 20–30 years) received a rapid intravenous injection and a single intramuscular dose and 12 other subjects (11 males, 1 female, age 21–25 years) a single oral and a single intramuscular dose of 20 mg of tenoxicam on two different occasions. The wash-out period between the two consecutive treatments was 4 weeks. Plasma concentrations after dosing were determined by a specific HPLC method. Differences in tenoxicam concentration-time profiles after the different routes of administration were limited to the first 2 h after dosing. Later, plasma concentrations were almost superimposable within and across the two studies. The extent of absorption of intramuscularly administered tenoxicam was complete (mean ± CV per cent: F_abs 0.99 ± 20 per cent) with no difference between the two extravascular administrations (F_rel 0.95 ± 10 per cent, intramuscular vs oral). After intramuscular administration tenoxicam was more rapidly absorbed compared to the oral dose (T_max 0.71 h ± 80 per cent vs 1.4 h ± 62 per cent; p>0.05). Peak concentrations after oral and intramuscular administration (C_max 2.5 mg 1^?1 ± 19 per cent vs 2.7 mg l^?1 14 per cent; p <0.05) were very similar.     

病人自控硬膜外镇痛用于肺癌术后的临床观察

目的 观察PCEA用于肺癌术后的镇痛效果。方法 60例肺癌术后患随机等分为两组：A组采用PCEA，B组肌注镇痛剂。定时监测两组MAP、HR、SpO2、VAS评分、镇静评分及不良反应等。结果 A组镇痛确切，呼吸、循环平稳，患平静合作休息好。结论 PCEA用于肺癌术后镇痛效果好，不良反应少，患满意度高。     

袖珍式野战静脉麻醉控制器的研制

介绍一种采用单片机开发的按药代动力学参数控制注射泵注射给药,从而控制手术患者静脉麻醉深度,适合野战条件下使用的小型化静脉麻醉系统.该系统具有控制精度高、功能扩展能力强以及使用方便等特点,并已在临床推广应用.     

几丁糖预防术后腹腔粘连的实验研究

目的探讨几丁糖对术后腹腔粘连的预防作用.方法将45只大鼠随机分为A、B、C 3组,于腹腔内浆膜损伤部位分别注入1%乳酸液、32%右旋糖酐-70液和2%几丁糖乳酸液各2 ml,术后14 d处死动物,观察各组腹腔粘连状况.结果 3组粘连分级比较有显著性差异(P＜0.01),C组粘连发生率与另2组有显著差异(P＜0.05).光镜下C组炎症反应轻微,纤维增生不明显;电镜下C组纤维细胞分泌胶原能力弱,间皮细胞增生活跃.结论几丁糖可有效降低大鼠术后腹腔粘连的发生和粘连程度,其作用优于右旋糖酐-70,且不影响切口的愈合.     

欧丹西酮预防曲马多硬膜外术后镇痛期间恶心、呕吐的定量研究

目的　寻找欧丹西酮 (Ondansetron)预防妇产科手术后曲马多连续硬膜外镇痛期间恶心和呕吐的最佳剂量。方法　ASAⅠ～Ⅱ级妇产科手术病人 12 0例 ,随机分为 4组 (n =30 ) ,于关腹后接镇痛泵前 (配方为曲马多 80 0mg+布比卡因 112 .5mg ,总量 10 0ml,泵速 2ml/h)分别接受欧丹西酮 2mg、4mg、6mg和生理盐水 2ml静注。观察镇痛期不同时点的VAS值和 0～ 2 4h的恶心、呕吐发生率。结果　 4组VAS均值无明显差异 (P >0 .0 5 )。在 0～2 4h ,恶心 :2mg组 30 .4 % (7) ,4mg组 3.3% (1) ,6mg组 3.3% (1)和生理盐水组 4 6 .7% (14 ) ;呕吐 :2mg组2 0 .0 % (6 ) ,4mg组 3.3% (1) ,6mg组 3.3% (1)生理盐水组 4 3.3% (13)。在预防恶心和呕吐两个事件方面 ,所有用药组与对照组相比均有显著差异 (P <0 .0 5 ) ;在用药组中 ,2mg组与 4mg和 6mg组间比较P <0 .0 5 ,而后 2个剂量组间无差别。结论　本文 3个剂量组的欧丹西酮均有预防妇产科手术后曲马多连续硬膜外镇痛期间恶心和呕吐的作用 ,其中以 4mg组最优。     

CO2 laser in cancer surgery of the breast: a comparative clinical study

Review of the literature reveals little to no data regarding the use of the CO2 laser as a surgical modality in the local treatment of breast cancer. This study was undertaken to determine if the CO2 laser is a surgical improvement over the scalpel, influencing patient care during the surgical and postsurgical period. In the author's series, a total of 209 procedures were performed. Within this group, 105 cases were performed with CO2 laser and 104 cases performed with the scalpel. Biopsies were always performed as a separate procedure prior to definitive surgery. This study was not designed to compare cure rates, the medical follow-up period being 1 year. The results of this study demonstrate a significant improvement in patients' postoperative care, surgical technique, and hospital cost-effectiveness.