双氯芬酸钠栓对局麻下剖宫产术后疼痛的疗效及护理

目的 探讨双氯芬硬钠栓直肠给药对局麻下剖宫产术后疼痛的疗效及护理措施。方法 60例患者随机分成两组，治疗组30例分别于术后10min、12h、24h各1次100mg双氯芬酸钠栓置入直肠内。对照组30例术后常规肌肉注射哌替啶镇病。结果 治疗组与对照组使用不同的镇病方法后，治疗组6h、12h、24h、36h的VAS疼痛评分明显小于对照组(P＜0．01)，24h内睡眠状况比较，治疗组亦显著好于对照组(P＜0．05)。恶心、呕吐等胃肠道不良反应两组差异无显著性(P＞0．05)，治疗组出汗反应明显多于对照组(P＜0．05)。结论 双氯芬酸钠栓直肠给药可作为局麻下剖宫产术后一种简单、有效、行之方便的镇病方法。早期干预、适时进行疼痛评估以及对患者进行心理指导是减轻术后疼痛的重要措施。     

双氯芬酸钠栓对局麻下剖宫产术后疼痛的影响

目的：观察双氯芬酸钠栓直肠给局麻下剖宫产术后疼痛的疗效。方法：60例患者随机分成两组，治疗组30例分别于术后10min、12h、24h各1次100mg双氯芬酸钠栓置入直肠内。对照组30例术后常规肌肉注射哌替啶镇痛。结果：治疗组6、12、24、36h的VAS疼痛评分明显小于对照组（P＜0．01），24h内睡眠状况比较，治疗组亦显著好于对照组（P＜0．05），恶心、呕吐等胃肠道不良反应两组差异无显著性（P＞0．05），治疗组出汗反应明显多于对照组（P＜0．05）。结论：双氯芬酸钠栓直肠治药可作为局麻下剖宫产术后一种简单、有效、行之方便的镇痛方法。     

双氯芬酸钠栓在腹腔镜术后镇痛的疗效观察

目的：评价双氯芬酸钠栓在腹腔镜术后的镇痛效果。方法：对2001年6月～2002年6月间共80例患者采用双氯芬酸钠栓经直肠给药，用于腹腔镜术后镇痛进行临床观察。结果：其镇痛作用最快5min，最慢2h，平均25min。镇痛持续时间最短5h，最长32h。总有效率93．7％。结论：双氯芬酸钠栓有镇痛效果好，持续时间长。对直肠局部刺激小，无明显副反应及无成瘾性等优点，是较为理想的无创伤性术后镇痛药物。     

双氯芬酸钠栓对剖宫产术后舒适度的影响

[目的]观察双氯芬酸钠栓提高剖宫产术后舒适度的效果。[方法]选择同期剖宫产术后病人100例,随机分为实验组和对照组各50例。术前均常规留置导尿管,术后24h拔除导尿管。对照组采用传统的拔除尿管法,实验组术毕给予双氯芬酸钠栓50mg塞肛,拔除尿管时,再予双氯芬酸钠栓50mg～100mg塞肛。比较两组的镇痛效果及术后恢复情况。[结果]实验组术后镇痛效果及满意度明显优于对照组(P<0.05),且术后24h内的睡眠时间较对照组延长,拔除尿管后排尿时间、下床活动及肛门排气时间均提前(P<0.05),术后舒适度提高。[结论]双氯芬酸钠栓塞肛用于剖宫产术后镇痛效果满意,对提高产妇术后舒适度和满意度有重要意义。     

剖宫产术后的护理

近年来剖宫产率居高不下，术后镇痛泵的广泛使用，各种先进仪器和设备的临床应用，使得剖宫产术后的及时护理显得尤为重要，笔者结合多年临床实践经验，谈谈当今剖宫产术后的及时护理。     

双氯芬酸钠栓与硬膜外镇痛泵在剖宫产术后的镇痛效果观察

[目的]探讨双氯芬酸钠栓与硬膜外镇痛泵在剖宫产术后的镇痛效果。[方法]抽取2004年8月—2007年4月剖宫产产妇184例,随机分为观察组和对照组,各92例,术后分别给予双氯芬酸钠栓与硬膜外镇痛泵镇痛,观察两组镇痛效果。[结果]剖宫产术后使用双氯芬酸钠栓镇痛效果与硬膜外镇痛泵镇痛效果相当。[结论]双氯芬酸钠栓镇痛操作简便、安全、吸收快、无副反应、经济,产妇容易接受。     

剖宫产术后镇痛方法的疗效观察与护理

剖宫产术后疼痛传统方法是肌注杜冷丁镇痛 ,其副作用多且效果不确切[1] 。 2 0 0 1年 7月至 2 0 0 2年 7月我院实施剖宫产术 180例 ,术后 6 0例采用一次性止痛泵止痛 ,6 0例用双氯酚酸钠栓止痛 ,观察 2种止痛方法的效果并与传统肌注杜冷丁止痛 6 0例比较 ,现将结果报告如下。1　资料与方法1 1　剖宫产 180例 ,2 1～ 38岁 ,妊娠37～ 4 3周 ,均在硬膜外麻醉下行子宫下段剖宫产术。随机分为 3组 ,实验Ａ、Ｂ两组及对照组各 6 0例 ,各组年龄、体重、孕周情况差异无显著性(Ｐ >0 0 5 ) ,有可比性。1 2　方法　实验Ａ组 :术后保留硬膜外导管接镇…     

PCA在剖宫产术后的应用及护理

病人自控镇痛(PCA)是一种全新的术后镇痛，因其简便、安全、镇痛的有效性。目前已被广泛地应用于术后镇痛。本文重点论述PCA用于剖宫产术后。应注意围术期宣教及护理。减少不良反应的发生。     

疼痛护理对剖宫产患者术后疼痛的影响

目的探讨疼痛护理对剖宫产患者术后疼痛的影响。方法将2011-02—12在我科进行手术的160例剖宫产患者随机分为观察组与对照组,对照组患者手术后采取常规护理干预,观察组患者在常规护理的基础上,采取疼痛护理干预。然后比较两组患者术后疼痛程度和术后疼痛评分情况。结果根据WHO对疼痛的分级,对照组患者能忍受的疼痛人数比例为30%,而观察组患者能忍受的疼痛人数比例高达90%,两组患者在术后疼痛程度上差异有统计学意义(P0.05);对照组术后疼痛评分(6.03±0.57)分,观察组术后疼痛评分(3.14±0.23)分,两组患者在术后疼痛评分上差异有统计学意义(P0.05)。结论对剖宫产患者进行有效的疼痛护理干预能够显著改善患者的疼痛症状,改善患者的术后生活质量,提高临床疗效。     

剖宫产术后病人疼痛评估及护理

剖宫产是处理高危妊娠的一种方法。剖宫产术后疼痛剧烈 ,如处理不当 ,不仅给产妇带来极大的痛苦 ,而且还可导致一些严重的并发症。因此 ,评估和控制疼痛一直是剖宫产术后护理探讨的重要内容。本文综合国内外相关资料将剖宫产术后疼痛评估及护理综述如下。1　剖宫产术后疼痛的机理手术导致组织创伤及机体受到伤害性刺激 ,组织细胞释放大量的炎性致痛物质 ,如缓激肽、组织胺、白三烯、前列腺素、花生四烯酸等 ,这些物质既可激活感受器产生痛觉 ,又可造成中枢敏感化 ,使其对疼痛刺激的反应强度增加。因此 ,术后疼痛除手术切口对神经末梢的机械…     

手术室外无痛苦性胃肠镜麻醉患者的护理

目的: 提高无痛苦性胃肠镜麻醉的护理水平.方法: 回顾性分析本院3年来28053例无痛苦性胃肠镜患者的临床资料.结果: 麻醉各个环节均发生过与麻醉或/和检查相关的不良反应,无严重麻醉并发症发生.近1年来,与护理相关的不良反应明显减少.结论: 在麻醉各个环节中,重视护理工作有助于预防和降低某些不良反应的发生.     

双氯酚酸超前镇痛用于小儿日间手术的效果

【目的】探讨双氯酚酸超前镇痛用于小儿日间手术的效果。【方法】选取进行日间手术的患儿138例,其中男120例,女18例,年龄11个月至7岁,体重10～30kg。根据给药时间的不同,将患儿随机分成实验组和对照组。对患儿苏醒时（P1）、苏醒后30min（P2）及60min（P3）分别进行疼痛评分并监测其生命体征。【结果】实验组患儿P1、P2时点的疼痛评分均明显低于对照组（P〈0．05）,P3时点两组疼痛评分比较无明显差异。【结论】双氯酚酸超前镇痛能部分有效地抑制小儿日间手术后疼痛。     

The Effect of Order on Pain of Local Anesthetic Infiltration

Objective: To define the relationship between order of injection and pain of infiltration of buffered lidocaine.
Methods: Volunteers ≥18 years of age were enrolled in a prospective, double-blind experimental protocol.
Subjects received a 0.5-mL intradermal injection of anesthetic in each forearm. All injections were given by the same individual in the same manner. Immediately following each injection, the subjects rated the pain of infiltration on a standardized 100-mm visual analog pain scale. Both the subjects and the individual giving the injections were blinded to the anesthetic being administered. They were told that the injections could be either plain or buffered lidocaine. They were further informed that any individual subject could receive 2 of the same anesthetics or 1 of each in either order. In reality, all injections were buffered lidocaine for all subjects. Pain scores were converted to a numerical score by making measurements to the nearest millimeter and analyzed by a Wilcoxon signed-rank test with p < 0.05 considered significant.
Results: Fifty subjects were enrolled. The first injection had a median pain score of 13.5 mm, compared with 23.5 mm for the second (p = 0.007).
Conclusion: The second injection of buffered lidocaine was found to be statistically more painful than the first in this protocol that controlled for all variables except for order of injection. Future studies involving paired comparisons should take this information into account.     

Analgesic Effect of Botulinum Toxin A in Myofascial Pain Syndrome Patients Previously Treated with Local Infiltration of Anesthetic and Steroids

The purpose of this study was to evaluate the analgesic effect of botulinum toxin A (BoNTA) injections in patients with myofascial pain syndrome (MPS) who were previously treated with the local infiltration of anesthetic and steroids (LIAS). The study included a retrospective phase and a longitudinal open-label prospective phase, which were conducted on consecutive patients with MPS previously treated with the local infiltration of anesthetic (levobupivacaíne 0.25%) and steroids (triamcinolone 40 mg). Eligible patients were treated with a single intramuscular injection of BoNTA (Botox; Allergan, Inc., Irvine, CA). The treatment efficacy was determined according to the degree of pain relief obtained. Eighty-two patients met the inclusion/exclusion criteria and were included in the study. Successful results were obtained for 32 (39.0%) and 30 (36.6%) patients, during treatment with BoNTA and LIAS, respectively. The mean (standard deviation) length of the analgesic effect was significantly longer with BoNTA (29.6 [SD = 17.7] weeks) than with LIAS (8.5 [SD = 6.4] weeks), P <.0001. As regards the side effects, 19 (23.2%) patients reported transient soreness at the injection site for 2 to 3 days with BoNTA. The MPS patients previously treated with a local infiltration of anesthetic and steroids who then received a single injection of BoNTA experienced significantly reduced pain for a relatively long time.     

Effect of Phonophoresis on Skin Permeation of Commercial Anti-inflammatory Gels: Sodium Diclofenac and Ketoprofen

This study evaluated the use of ultrasound in combination with the commercial anti-inflammatory drugs ketoprofen and sodium diclofenac, according to the parameters used in physiotherapy. Ketoprofen and sodium diclofenac were used in the Franz diffusion cell model adapted to an ultrasound transducer in three conditions: no ultrasound, one application of ultrasound and two applications of ultrasound. High-performance liquid chromatography was used to quantify the total amount of drug permeating skin per unit area, as well as flux and latency. The results showed that for ketoprofen, the amount of drug permeating skin and flux increased with two ultrasound applications. Permeation of sodium diclofenac decreased in the presence of ultrasound. Ultrasound parameters and drug properties must be considered in the use of phonophoresis.     

特拉唑嗪与双氯芬酸钠联用同单用特拉唑嗪排石效果比较

目的：比较特拉唑嗪与双氯芬酸钠联用同单用特拉唑嗪对输尿管末端结石排石效果。方法：联合用药组输尿管末端结石患者45例,特拉唑嗪2 mg/d,双氯芬酸钠25 mg/次,2次/d;单用药组38例,特拉唑嗪2 mg/d。比较两组结石排出率、肾绞痛缓解率、肾绞痛复发率和药物不良反应。结果：两组在结石排出率、排出时间、药物不良反应比较无统计学意义（P〉0.05）;肾绞痛缓解率和肾绞痛复发率两组比较有统计学差异（P〈0.05）。结论：特拉唑嗪与双氯芬酸钠较单用特拉唑嗪能更强地解除肾绞痛,并减少肾绞痛复发率。     

布比卡因、左旋布比卡因和罗哌卡因的剖宫产硬膜外阻滞效果比较

目的:比较3种局麻药用于剖宫产硬膜外阻滞的麻醉效果与不良反应。方法:在硬膜外阻滞下行剖宫产手术的90例产妇被随机分为3组。硬膜外穿刺置管成功后,先给试验量含1:200 000肾上腺素的2%利多卡因3 ml,再分别给予浓度均为0.5%的布比卡因、左旋布比卡因和罗哌卡因中的一种,分次给药。记录各组的感觉和运动阻滞的起效、时效及不良反应。结果:3组均有较好的麻醉镇痛效果,但有一些肌松不满意的病例。罗哌卡因组的感觉阻滞起效、时效较其他两组长,但尚无统计学差异;其运动阻滞起效与时效和运动阻滞程度均不及其他两组,且有统计学差异(P<0.05)。3组均未发生严重不良反应。结论:硬膜外0.5%布比卡因、左旋布比卡因或罗哌卡因用于剖宫产均有较好的麻醉镇痛效果,有一些肌松不满意的病例;但罗哌卡因的运动阻滞起效与时效和运动阻滞程度均不及其他两药。