25G细针腰麻在老年患者麻醉中的应用分析

目的 探讨25G细针腰麻在老年患者麻醉中的应用有效性与安全性.方法 方便选取2015年6月—2016年12月该院收治的120例老年下肢手术患者为研究对象,依据麻醉方式分为实验组(25G细针腰麻,60例)和对照组(腰硬联合麻醉,60例).对比观察两组麻醉完成时间、感觉阻滞起效时间、术中麻醉效果、术中血压、心率及术后并发症.结果 实验组麻醉完成时间(137.8±29.6)s,术后神经损伤10.0%,腰背痛13.3%,头痛6.7%,与对照组比较差异有统计学意义(P<0.05).实验组术中不同时刻,患者心率、血压无明显波动.结论 25G细针腰麻用于老年麻醉具有操作方便、起效快、效果确切、循环稳定、并发症少的优点,具备临床推广价值.     

9号皮针引导25G腰穿针腰麻临床应用

目的探讨9号皮针引导下25G细针腰麻穿刺的可行性。方法选择下肢、会阴及盆腹腔手术患者60例,随机分成腰硬联合麻醉(对照组)和皮针引导细针组(实验组)。观察细腰针脊麻穿刺成功率、黄韧带和硬脊膜突破感知率、腰穿后脑脊液流出率及术后穿刺点和腰痛发生率。结果脊麻注药完成以后,两组感觉阻滞平面、T10感觉阻滞起效时间和运动神经阻滞起效时间比较,无显著性差异(P>0.05)。实验组穿刺时间(71.18±13.2)s,长于对照组的(55.10±15.8)s,有显著性差异(P<0.01)。实验组细针腰麻成功率93.3%优于联合麻醉组的76.7%;实验组腰穿成功后脑脊液流出通畅,优于联合麻醉组(P<0.05);术后穿刺点和腰痛发生率17.9%低于联合麻醉组的36.7%;两组细腰针突破硬脊膜时均有确切的纸质破裂感或阻力落空感,无显著差异(P>0.05)。结论 9号皮针引导25G细针腰穿可以确切感知突破硬脊膜,脑脊液流出通畅,腰麻麻醉效果确切,减少术后穿刺点及腰痛发生,相对于联合麻醉,并不增加穿刺过程中引起的神经损伤,适用于年轻患者的下肢、会阴及盆腹腔手术麻醉。     

针内针单纯腰麻和腰硬联合麻醉在剖宫产术中的麻醉效果比较

目的探讨分析针内针单纯腰麻和腰硬联合麻醉在剖宫产术中的麻醉效果。方法将2009年4月—2013年3月期间在该院行剖宫产术的108例产妇随机分为研究组与对照组,每组患者54例,研究组接受针内针单纯腰麻,对照组患者接受腰硬联合麻醉,现对比分析两组患者的麻醉效果。结果两组患者麻醉起效时间、呼吸困难发生率、麻醉平面、术后VAS评分相比,差异无统计学意义(P>0.05),研究组寒颤发生率、术后恶性呕吐发生率显著高于对照组,两组比较差异有统计学意义(P<0.05),研究组低血压发生率、术后腰酸腰痛发生率显著低于对照组,两组比较差异有统计学意义(P<0.05)。结论针内针单纯腰麻和腰硬联合麻醉在剖宫产术中的麻醉效果相当,但不良反应发生率各有特点,在剖宫产术中选择适宜的麻醉方式需要考虑多方面因素。     

细针直接穿刺腰麻联合使用重比重局麻药在产科麻醉中的临床应用

目的:探讨分析细针直接穿刺腰麻联合使用重比重局麻药在产科麻醉中的临床应用。方法:收集2018年1月—2019年1月我院产科麻醉使用细针(25G笔直式针)直接穿刺联合应用重比重局麻药手术的34例患者作为A组,回顾分析2016年1月—2017年12月我院产科采用传统腰硬联合麻醉联合应用重比重局麻药手术的34例患者作为B组,对比2组穿刺操作时间、穿刺成功所需次数、麻醉效果、并发症。结果:A组穿刺操作所需时间明显比B组短,成功穿刺所需次数明显比B组少,差异具有高度统计学意义(P<0.01);A组麻醉成功率高于B组,差异具有统计学意义(P<0.05);A组并发症发生率低于B组,差异具有高度统计学意义(P<0.01)。结论:细针直接穿刺腰麻联合使用重比重局麻药在产科麻醉时,术者熟练掌握操作要领能够起到良好的麻醉效果且安全性佳。     

腰-硬联合麻醉应用罗哌卡因和布比卡因对老年下肢手术患者的麻醉效果比较

目的:探讨腰-硬联合麻醉应用罗哌卡因和布比卡因对老年下肢手术患者的麻醉效果。方法:将90例老年下肢手术患者应用随机数字表法分组。对照组用布比卡因腰-硬联合麻醉,观察组进行罗哌卡因腰-硬联合麻醉。比较两组老年下肢手术麻醉效能;血压下降等并发症发生率;干预前后患者循环指标。麻醉起效时间、麻醉维持时间、最高阻滞平面、达到最高阻滞平面所需时间。结果:观察组老年下肢手术麻醉效能和对照组相似,差异无统计学意义(P>0. 05);观察组血压下降等并发症发生率和对照组相似,差异无统计学意义(P> 0. 05);干预前两组循环指标相近,差异无统计学意义(P> 0. 05);干预后观察组循环指标和对照组相似,差异无统计学意义(P> 0. 05)。观察组麻醉起效时间快于对照组,麻醉维持时间长于对照组,差异有统计学意义(P <0. 05)。观察组最高阻滞平面、达到最高阻滞平面所需时间和对照组相似,差异无统计学意义(P> 0. 05)。结论:罗哌卡因腰-硬联合麻醉在老年下肢手术麻醉中的效果确切,可更快发挥阻滞作用,且阻滞维持的时间更长,相对于布比卡因而言有明显优势。     

腰麻联合硬膜外麻醉在老年股骨颈骨折患者手术中的应用

目的探讨老年股骨颈骨折手术患者实施腰麻联合硬膜外麻醉的临床效果。方法随机选取上蔡协和医院2012年11月至2015年1月期间收治的老年股骨颈骨折患者74例,按照麻醉方式的不同将其分为观察组和对照组,对照组患者行全身麻醉,观察组患者行腰麻联合硬膜外麻醉,对两组患者的麻醉效果及并发症发生情况进行分析。结果观察组患者麻醉期间低血压发生率明显高于对照组,高血压发生率明显低于对照组,差异均有统计学意义(P<0.05);观察组患者术后VAS评分明显低于对照组(P<0.05);观察组患者并发症发生率明显低于对照组(P<0.05)。结论老年股骨颈骨折手术患者实施腰麻联合硬膜外麻醉,能有效缓解疼痛,降低并发症发生率,值得推广。     

腰麻同腰硬联合麻醉在老年下肢手术中的应用价值

目的研究探讨腰麻同腰硬联合麻醉在老年下肢手术中的临床应用价值。方法将我院2014年3月至2015年3月实行下肢手术的老年患者84例按照统计学原理分为例数均为42例的对照组和观察组。对照组患者实行单纯采取腰麻方式展开手术,观察组患者实行腰麻同腰硬联合麻醉方式实行手术,比较两组患者的麻醉效果。结果结果表明,观察组患者镇痛有效率为95.2%,对照组患者麻醉镇痛有效率为83.3%,数据符合统计学差异(P0.05);与此同时,观察组患者不良反应发生率明显低于对照组患者,数据符合统计学差异(P0.05);且观察组患者在麻醉后的5min与15min时间段血压与心率明显高于对照组,数据符合统计学差异(P0.05)。结论在老年患者展开下肢手术的时候,采取腰麻同腰硬联合麻醉方法,可产生良好的镇痛效果,有效减少并发症的产生,保持患者血流动力学的稳定,可在临床上推广应用。     

改良25G细针旁正中入路腰麻对剖宫产麻醉效果的影响

目的：探讨改良25G细针旁正中入路腰麻对剖宫产麻醉效果的影响。方法：选择2019年1月—2021年1月于我院行剖宫产的82例产妇作为观察对象，按便利抽样法分为A组(41例)与B组(41例),A组实施传统针内针正中入路组腰麻，B组实施改良25G细针旁正中入路腰麻。对比两组的穿刺相关指标、血流动力学、镇痛效果、阻滞情况、并发症情况。结果：B组的总穿刺时间短于A组，穿刺次数、针尖接触骨骼次数少于A组，穿刺深度小于A组(P<0.05),两组的一次穿刺成功率无显著差异(P>0.05);进入手术室后(T1)、麻醉后30min(T2),两组的收缩压、舒张压、心率、血氧饱和度(SpO₂)对比无统计学差异(P>0.05);两组的镇痛效果及感觉、运动阻滞起效时间对比无统计学差异(P>0.05);B组的并发症总发生率低于A组(P<0.05)。结论：无论行传统针内针正中入路还是改良25G细针旁正中入路腰麻，均可稳定患者术中的血流动力学，有效阻滞感觉和运动神经，镇痛效果均较好，但后者入路方式具有缩短穿刺时间、减少穿刺次数和穿刺深度的优势，不会影响穿刺成功率，还...     

腰硬联合麻醉在老年下肢骨折手术患者中的应用效果观察

目的 探讨腰硬联合麻醉在老年下肢骨折手术患者中的应用效果.方法 选择我院2009年4月至2011年4月实施下肢骨折手术的老年患者共60例,以上患者均为ASAⅠ～Ⅱ级.将以上患者随机分为两组,观察组和对照组.观察组实施腰硬联合麻醉.对照组手术硬膜外麻醉.记录两组麻醉起效时间、运动阻滞起效时间;记录每分钟内麻醉药的用量情况.结果 观察组麻醉起效时间、运动阻滞起效时间早于对照组,差异有统计学意义(P<0.05);观察组每分钟麻醉药用量显著低于对照组,差异有统计学意义(P<0.05).结论 腰硬联合麻醉用于老年下肢骨折手术具有麻醉起效快、麻醉用药量小、麻醉效果确切等优点,由于硬膜外麻醉,值得借鉴.     

腰硬联合麻醉和全身麻醉在老年下肢骨折手术中的作用对照研究

目的:探讨腰硬联合麻醉与全身麻醉在老年下肢骨折手术中的应用效果。方法:2017年4月-2019年6月,将106例老年下肢骨折患者作为研究对象,按照随机数表法分为对照组53例(全身麻醉);观察组53例(腰硬联合麻醉),对比2组患者的麻醉效果、不良反应以及各项临床指标。结果:麻醉后,对照组患者不良反应发生率为28.30%,明显高于观察组5.65%(P<0.05)。对照组患者感觉阻滞起效时间、起效所用时间、运动神经阻滞持续时间,明显长于观察组,且镇痛维持时间明显短于观察组(P<0.05)。对照组患者临床麻醉优良率为73.58%,明显低于观察组94.34%(P<0.05)。结论:通过对比腰硬联合麻醉和全身麻醉方法,分别用于老年下肢骨折手术中的麻醉效果,结果证实腰硬联合麻醉优于全身麻醉,能够缩短感觉阻滞起效时间、起效所用时间、运动神经阻滞持续时间,延长镇痛维持时间,减少不良反应的发生,提高麻醉效果,可供临床用药选择参考。     

Anesthesia

Effects of DO2-directed hemodynamic management on pulmonary function in to course of anaesthesia of liver transplantation; Rectal midazolam, atropine and ketamine as premedication for infants and young children; Supraclavicular subclavian venous catheterization through the insertion point medial to the middle of clavicle in infants; Effect of acute normovolemic hemodilution on context-sensitive half-time for propofol given by target controlled infusion during hip joint replacement; Effect of acute hypervolemic hemodilution on pharmacokinetics of propofol in patients undergoing total hip replacement; Influence of leukocyte filtration on systemic inflammatory response to cardiopulmonary bypass in dogs;Effect of urapidil on L-type calcium current in rat ventricular myocytes; Changes in systemic and pulmonary hemodynamics in patients with liver cirrhosis and portopulmonary hypertension during liver transplantation;……     

Anesthesia

Effect of propofol on the release of glutamate γ-amino-butyric acid in hippocampus in rats during recovery from paradoxical steep deprivation;The effect-site concentration of midazolam achninistered by TCI and BIS values for conscious sedation in patients of differmt ages;Effects of ephedrine pretreatment and rocuronium priming on the rocuronium-induced neuromuscular blockade;Effects of different doses of propofol on cerebral venous blood S-100 protein and neuron-specific eno- lase in patients undergoing open heart surgery under CPB at mild hypothermia;Effect of different doses of ambroxol in car- diopulmonary bypass induced lung injury in children     

Anesthesia

Protective effects of colquhounia root tablet against oleic acid induced acute lung injury in rats , Effect of ketamine on iNOS mRNA expression in spinal cord of mice in the development of morphine tolerance, Analgesic effect of intrathecal SB203580 in a rat model of neuropathic pain , Interleukin.lO gene therapy for neuropathic pain in a rat model of chronic constriction injury , Effects of epidural capsaicin on pain thresh. old, neurological function and spinal neurons in rabbits, Effects of different concentrations of heparin in the preservation solution on blood coagulation after reperfusion in patients undergoing orthotopie liver transplantation, Influence of lidocaine on systemic inflammatory response to cardiopulmonary bypass in patients undergoing coronary artery bypass grafting , Effect of midazolam pretreatment on neurotoxicity of ropivacaine in rats , Anesthetic efficacy of epidural ropivaeaine mixed with different doses of sufentanil for hysterectomy     

Anesthesia

<正>209016 Effects of flurbiprofen on cellular immune function during patient-controlled intravenous analgesia with fentanyl in patients after esophagectomy/Feng Yanping(冯艳平,Dept Anesthesiol,Cancer Hosp He’nan Province,Zhengzhou 450003)…∥Chin J Anesthesiol. -2009,29(9). -773～774 Objective To investigate the effects of flurbiprofen on cellular immune function during patient-controlled in- travenous analgesia(PCIA) with fentanyl in the patients after esophagectomy.     

Anesthesia

<正>209163 Changes in plasma colloid osmotic pressure during off-pump orthotopic liver transplantation/Zhang Xiaomei(Dept Anesthesiol,Tianjin 1st Centre Hosp,Tianjian 300192)…∥Chin J Anesthesiol.-2009,29(2).-151~153Objective To investigate the changes in plasma colloid osmotic pressure(COP)in patients undergoing off-pump orthotopic liver transplantation(OLT).Methods Thirty ASA Ⅱ-Ⅳ patients(liver function Child-Pugh grade B or C)aged 35-60 yr undergoing off-pump OLT were studied.Anesthesia was induced with midazolam,sufentanil,propofol and vecuronium and maintained with propofol infusion,isoflurane inhalation and intermittent iv boluses of sufentanil and vecuronium.Human albumin and fresh frozen plasma were infused during operation.Hemoglobin was maintained at 70-80 and 80-100 g/L during preanhepatic and anhepatic phase respectively.Urine output was maintained at 1,0.5 and 1-2 ml·kg-1·min-1 while CVP at 4-7,0-3 and 4-10 mm Hg respectively during preanhepatic,anhepatic and neo-hepatic phase.Blood samples were taken immediately before intravenous line was established (T0,baseline),at skin incision(T1),60 min of preanhepatic phase(T2)beginning of anhepatic phase(T3),30 min of anhepatic phase (T4),beginning of neohepatic phase(T5),30 min of neohepatic phase(T6) and the end of operation(T7)from internal jugular vein for determination of plasma COP,crystalloid osmotic pressure and serum albumin concentration.     

Anesthesia

Preventive effects of remifentanil on sympathetic activation induced by desflurane,Effects of different doses of ketamine on cognitive function in aged rats,Efficacy of sufentanil combined with propofol for video-assisted endoscopic transthoracic sympathectomy,Accuracy of target-controlled infusion of sufentanil in clinical anesthesia.     

Anesthesia

Anesthetic choice for patients undergoing simuitaneous pancreas-kidney transplantation,Effect of morphine pretrealment on expression of substance P and calcitonin gene related peptide in myocardium following acute myocardial ischemia in rats,Effects of lidocaine and ropivacaine on con- tractility of isolated pregnarlt rat myometrium,Effect of acute hypervolemic hemodilution with different colloids on GP Ⅱ b/Ⅲ a and P-selectin expression in patients with colon cancer during perioperative period,Effects of propofol on extracellular signal-regulated kinase 1/2 phosphorylation in mouse hippocampal slices[第一段]     

Anesthesia

Cerebral protective effect of nicorandil premedication in patients undergoing coronary artery bypass grafting with cardiopuimonary bypass;Protective effects of remifentanil preconditioning on myocardium against ischemia-reperfusion injury in rats; Effects of ultrarapid opiate detoxification during general anesthesia on plasma morphine concentration and brain β-endorphin content in rats addicted to morphine;The effect of propofol on platelet aggregation and blood coagulation in patients undergoing upper ab- dominal surgery/Tao Guocai ; Protective effects of pretreatment with rosigli tazone on the lungs against endotoxin-induced acute injm＇y in rats; ……     

Anesthesia

<正>209480 Effect of high thoracic epidural block on expression of β1-ARK mRNA in lymphocytes in elderly patients with essential hypertension complicated with     

Anesthesia

Efficacy and safety of intravenous dexmedetomidine as an adjunct to general anesthesia; Difference in BIS level between adults and children during target-controlled infusion of propofol; Recovery from anesthesia in patients undergoing abdominal surgery： a comparison of sevoflurane and isoflurane