The effects of sedative and stimulative music on stress reduction depend on music preference

To examine the effects of sedative and stimulative music and music preference on stress reduction when participants are exposed to a stressor, 144 female music education students performed a stressful, mental arithmetic test. After the stress was induced successfully, participants were randomly assigned to four experimental groups. They listened to preferred sedative music, preferred stimulative music, unpreferred sedative music, and unpreferred stimulative music, respectively. Tension and state-anxiety levels were obtained after listening to music. The results revealed that participants who listened to sedative music showed significantly lower tension and state-anxiety levels than did those who listened to stimulative music when music was unpreferred. However, there was no significant difference of tension and state-anxiety levels between listening to sedative music and stimulative music when music was preferred. These findings demonstrate that the effects of sedative and stimulative music on stress reduction depend on music preference. Our study has important implications for the practice of clinical music therapy since it provides strong support for the use of preferred music when working to reduce patient stress.     

Medicación preanestésica con dexmedetomidina intranasal y midazolam oral como ansiolítico. Un ensayo clínico

IntroductionDexmedetomidine is a pharmacological option for sedation in children. In this study, the efficacy of intranasal dexmedetomidine to reduce preoperative anxiety in pediatric patients is compared with that of oral midazolam.Material and methodsA prospective, randomized, double-blind, controlled trial was conducted on children 2-12 years of age, randomly assigned to one of the following two groups: group A received premedication with oral midazolam and intranasal placebo, group B received intranasal dexmedetomidine and oral placebo. Anxiety was assessed with the modified Yale scale, and a risk analysis and number needed to treat was performed.ResultsA total of 108 patients were included, 52 (48.1%) treated with dexmedetomidine, and 56 (51.9%) with midazolam. Anxiety was less frequent in the dexmedetomidine group at 60 minutes (P=.001), induction (p=.04), and recovery (P=.0001). Risk analysis showed that dexmedetomidine reduced the risk of anxiety by 28% (RAR = 0.28, 95% CI; 0.12 to 0.43) and to prevent one case of anxiety, four patients need to be treated with intranasal dexmedetomidine (NNT = 4, 95% CI: 3-9).Changes in heart rate, mean arterial pressure, and oxygen saturation, were statistically significant in the dexmedetomidine group, with no clinical consequences. There were no cases of bradycardia, hypotension or oxygen desaturation.ConclusionsIntranasal dexmedetomidine premedication is more effective than oral midazolam to reduce preoperative anxiety in pediatric patients.     

柏子仁总萜类成分药理活性及提取工艺研究

目的探讨从柏子仁中提取总萜类成分的最佳工艺及总萜类成分的镇静、催眠和耐缺氧作用。方法以均质时间、温度、料液比和次数4个因素进行考察,每个因素3个水平,采用L9(34)正交试验优选提取工艺。观察柏子仁总萜类成分对小鼠自发活动、戊巴比妥钠诱导小鼠睡眠时间和睡眠个数及缺氧小鼠存活时间的影响。结果以甲醇溶液作为提取溶剂,提取温度80℃,料液比1∶10,均质10 min,均质提取1次为最佳提取工艺;总萜类成分能抑制小鼠的自发活动,延长戊巴比妥钠诱导的小鼠睡眠时间,增加小鼠睡眠个数,延长缺氧小鼠的存活时间。结论柏子仁总萜类成分具有镇静、催眠和耐缺氧作用;提取方法应用均质法操作简单、效率高,适用于柏子仁总萜类成分的提取。     

镇静/镇痛药对肝叶切除患者全身麻醉恢复期镇静程度的影响

目的:探讨镇静/镇痛药对肝叶切除患者全身麻醉恢复期镇静程度的影响。方法:回顾我院择期行肝叶切除术肝功能正常全麻患者72例,年龄(58.39±9.54)岁,体重(58.51±8.53)kg,美国麻醉师协会(ASA)分级Ⅰ～Ⅱ级。根据Riker镇静-躁动分级分成3组,即躁动组(Riker5～7级)、平静合作组(Riker4级)、嗜睡组(Riker3级)。对比3组镇静/镇痛药用量。结果:躁动组13例,平静合作组45例,嗜睡组14例。3组一般情况、麻醉时间、总液体入量、术中血流动力学波动及维库溴铵的用量差异均无统计学意义(P>0.05)。嗜睡组咪达唑仑及舒芬太尼用量明显多于躁动组(P<0.05)。结论:嗜睡者的镇静/镇痛药用量明显多于躁动者。     

120例海洛因依赖者使用镇静催眠药物情况分析

目的：了解强制隔离戒毒中心海洛因依赖者使用镇静催眠药物情况。方法：自编镇静催眠药物使用调查表,对2010年在所的海洛因依赖者合并镇静催眠药物的共计120例进行调查。调查项目包括一般情况、药物使用种类、使用原因、使用方法、使用次数和剂量等,并逐一进行分析。结果：海洛因依赖者合并使用镇静催眠药占35．7％,其中发生依赖为39．1％。用于镇静催眠占70．12％;使用种类以氯硝西泮为主,占72．5％;结论：海洛因依赖者因失眠、焦虑等症状确有必要使用镇静催眠药,但是应严格控制适应症与时间,以免造成医源性药物滥用。     

Propofol vs traditional sedative agents for endoscopic retrograde cholangiopancreatography: a meta-analysis

AIM:To investigate the efficacy and safety of propofol sedation for endoscopic retrograde cholangiopancreatography(ERCP).METHODS:Databases including PubMed,Embase,and the Cochrane Central Register of Controlled Trials updated as of October 2010 were searched.Main outcome measures were ERCP procedure duration,recovery time,incidence of hypotension and hypoxia.RESULTS:Six trials with a total of 663 patients were included.The pooled mean difference in ERCP procedure duration between the propofol and traditiona...     

无创正压通气联合纤维支气管镜吸痰和（或）镇静剂治疗肺心病并肺性脑

目的：探讨无创正压通气（NIPPV）联合镇静剂和（或）纤维支气管镜（纤支镜）吸痰治疗肺心病并肺性脑病患者的疗效和安全性。方法：实验组25例,在常规治疗的基础上,应用NIPPV联合纤支镜检查行深部痰细菌培养和清除分泌物,并依据病情必要时予镇静剂。对照组为同期达到同样标准的患者25例,对治疗前、中、后行实验室指标、生命体征、脉搏、血氧饱和度、血气分析等观察监测。结果：实验组患者均能进行NIPPV治疗,通气前、后PaCO2分别为（11.05±2.14）kPa和（7.85±1.69）kPa,PaO2分别为（7.81±1.87）kPa和（11.14±2.07）kPa,通气后患者病情有显著改善（P〈0.01）;实验组患者均行纤支镜吸痰并均取得了合格的深部痰标本,操作过程无并发症;与对照组比较,实验组的痰菌阳性率（72%vs32%）、插管率（32%vs 60.0%）、病死率（20%vs 52.0%）、住院天数（21.4±7.5）d vs（34.3±12.3）d,差异均有统计学意义（P〈0.01）。实验组有11例患者接受镇静剂治疗。结论：NIPPV联合镇静剂和（或）纤支镜吸痰治疗老年肺心病并肺性脑病患者的效果良好;应用镇静剂时,应做好机械通气的准备。     

我院口服镇静催眠药应用分析

目的：了解我院近3年来口服镇静催眠药的用药变化情况,探讨其使用特点及趋势,更加合理使用镇静催眠药。方法：对2006～2008年我院口服镇静催眠药的购药金额、用药频度（DDDs）及药品限定日费用（DDC）等数据进行统计分析。结果：马来酸咪达唑仑、酒石酸唑吡坦和百乐眠购药金额排在前3位,艾司唑仑、地西泮、氯硝西泮及马来酸咪达唑仑的DDDs位于前列,新型镇静催眠药和中成药的治疗地位不断上升。结论：口服镇静催眠药在我院使用较为普遍,应加强认知行为治疗,降低药物依赖性。